UMASS/AMHERST. 


31E0bbDDSflE7313 


vEPORT 


Special  Milk  Board 


Massachusetts  State  Department  of  Health. 


Submitted  to  the  Commissioner  of  Health  and  Public 
Health  Council  Decembeb  29,  1915. 


BOSTON: 

WEIGHT  &  POTTEE  PEINTING  CO.,  STATE  PEINTEES, 

32  DEENE  STEEET. 

1916. 


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REPORT 


Special  Milk  Board 


Massachusetts  State  Department  of  Health. 


Submitted  to  the  Commissionee  op  Health  and  Public 
Health  Council  December  29,  1915. 


BOSTON: 

WEIGHT  &  POTTER  PRINTING  CO.,  STATE  PRINTEES, 

32  DEENE  STEEET. 

1916. 


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State  Department  of  Health,  Boston,  Dec.  29,  1915. 
To  the  Commissioner  of  Health  and  Public  Health  Council. 

Gentlemen  :  —  The  Special  Board  of  this  Department  ap- 
pointed to  investigate  the  status  of  milk  production,  distribu- 
tion and  inspection,  and  the  relation  thereof  to  the  public 
health  of  this  Commonwealth,  by  an  order  of  the  Commissioner 
of  Health  of  March  29,  1915,  has  the  honor  to  present  here- 
with the  accompanying  report. 

Respectfully  submitted, 

EUGENE  R.   KELLEY,  Chairman, 
JOSEPH  E.  LAMOUREUX, 
HERMANN  C.  LYTHGOE, 
EDWARD   H.   WILLIAMS,  Recorder, 

Members  of  the  Board. 


TABLE  OF  CONTENTS. 


B. 


C. 
D. 


B. 


D. 
E. 

F. 

G. 

H. 


B. 


C. 


D. 


Williams, 


Preface,  by  Allan  J.  McLaughlin, 

Introduction, 

Abstract  of  Report,     . 

Conclusions, 

Part  I.     Historical, 

A.     Development  of  Present  Milk  Controversy,  by  Edward  H 
Earlier  Investigations,  by  Dr.  Eugene  R.  Kelley, 

1.  Legislative  Inquiry  of  1910,  .... 

2.  Special  Milk  Commission  of  1910, 

3.  Boston  Chamber  of  Commerce  Investigation  of  1915, 
Summary  of  Proposed  Laws  relating  to  Milk,  by  Dr.  Lewis  Fish, 1 
Summary  of  Present  Milk  Laws,  by  Hermann  C.  Lythgoe, 

Part  II.     Statements  of  Various  Interests,         .... 
A.     Milk  Contractors,  compiled  by  Hermann  C.  Lythgoe, 

Boston  Chamber  of  Commerce,  by  John  C.  Orcutt,  Assistant  Secre- 
tary, .......... 

Milk  Consumers'  League,  by  Myron  L.  Pierce,  Council  of  Milk  Con- 
sumer's League,  ........ 

The  State  Grange,  by  Hon.  Chas.  M.  Gardner,  . 

Milk  and  Baby  Hygiene  Associations,  by  Dr.  J.  Herbert  Young 
Medical  Director,  Boston  Milk  and  Baby  Hygiene  Association, 

City  of  Boston  Health  Department,  by  Dr.  Francis  X.  Mahoney, 
Health  Commissioner,  .  . 

Massachusetts  State  Board  of  Agriculture,  by  Wilfrid  Wheeler 
Secretary,  ......... 

Massachusetts  State  Department  of  Animal  Industry,  by  Dr.  Lester 
H.  Howard,  Commissioner,  .  .  .  . 

I.      Cattle  Breeders'  Associations,  compiled  by  Edward  H.  Williams, 
Part  III.     Facts  of  Production,  Processing  and  Marketing, 

A.     Summary  of   Milk  Board's  Own  Dairy  Inspections,   by   Dr.   Lewis 
Fish 

Compilation  of  Milk  Contractor's  Statements,  by  Dr.  Eugene  R 
Kelley  and  Hermann  C.  Lythgoe,  ..... 

Observations  on  Past  and  Present  Increase,  Decrease,  Fluctuations 
and  Geographical  Movements  of  Commercial  Milk  and  Cream 
Production  in  Massachusetts  and  Neighboring  States  and  the 
Province  of  Quebec  in  Relation  to  the  Milk  Supply  of  this  Com- 
monwealth, by  Edward  H.  Williams,      ...... 

The  Commercial  Pasteurization  of  Milk  and  Cream,  by  Hermann  C. 
Lythgoe,    ........... 

Part  IV.     Facts  of  the  Present  Official  Supervision  of  the  Milk 
Supply  of  this  Commonwealth,  by  Hermann  C.  Lythgoe,  . 

A.  Present   Status   of   Official   Supervision   of  the   Massachusetts   Milk 

Supply  by  Federal,  State  and  Local  Authorities,     .... 

B.  Present  Status  of  Local  Milk  Inspection,  .  . 

C.  Discussion  of  Present  System  of  Dairy  Inspection  and  its  Sanitary 

Value,    ........... 


11 
13 
22 
27 
27 
29 
30 
31 
32 
33 
37 
42 
42 

46 

47 
49 

51 

52 

53 

55 

58 
60 

60 

73 


77 
105 
110 

110 

117 

121 


1  Proposed  laws  for  1914  summarized  by  E.  H.  Williams. 


PAGE 

Part  V.  The  Relationship  between  Cow's  Milk  and  the  Public 
Health,  by  Dr.  Eugene  R.  Kelley,  Dr.  Lewis  Fish  and  Dr.  John 
S.  Hitchcock 126 

A.  Introduction,  by  Dr.  Eugene  R.  Kelley,   ......     126 

B.  Milk  and  the  Communicable  Diseases,      ......     128 

1.  Milk  and  Tuberculosis,  by  Dr.  Eugene  R.  Kelley,  .  .  .     128 

2.  Methods  of  Infection  of  Milk  by  Diphtheria,  Scarlet  Fever,  Septic 
Sore  Throat  and  Typhoid  Fever,  by  Dr.  Lewis  Fish,        .  .  .     135 

3.  Communicable  Diseases  of  Minor  Significance  or  Relative  In- 
frequency,  in  which  Milk  is  concerned  as  an  Agent  of  Transmission, 

by  Dr.  Eugene  R.  Kelley 137 

4.  The  Evidence  Available  as  to  the  Relative  Importance  of  Milk 
as  a  Means  of  Transmission  of  Communicable  Diseases,  compared 
with    Other   Means   of   Transmission,  by    Dr.   Eugene    R.  Kelley,     138 

5.  The  Possible  Means  of  preventing  Communicable  Disease  Trans- 
mission through  Milk,  and  their  Relative  Practicability,  by  Dr. 
Eugene  R.  Kelley, 166 

6.  Pasteurization  as  a  Means  of  Infectious  Disease  Prevention,  by . 

Dr.  Eugene  R.  Kelley, 168 

C.  Milk  and  Infant  Mortality,  by  Dr.  John  S.  Hitchcock,  .  .  .172 
>/  D.  The  Nutritional  Value  of  Milk,  by  Dr.  John  S.  Hitchcock,  .'  .  185 
Part  VI.     Grading  of  Milk,  by  Hermann  C.  Lythgoe,   ....     190 

A.  General  Discussion,         .........     190 

B.  Relation  between  Solids  and  Fats  in  Milk,  .....  200 
Part  VII.     Experiences  of  Other  Localities,      .....     206 

A.  Report  on  an  Investigation  of  the  New  York  City   Milk  Grading 

System  in  the  City  of  New  York,  by  Hermann  C.  Lythgoe,     .  .     206 

B.  Report  on  a  Special  Investigation  of  the  Efficiency  of  the  New  York 

Grading  System  in  the  Producing  Area,  by  Clarence  E.  Marsh,  .     214 

C.  Report  on  a  Special  Investigation  of  the  New  York  Grading  System 

in  the  Producing  Area,  by  Charles  H.  Hickey,         ....     216 

D.  Copy  of  an  Article  by  Lucius  P.  Brown  of  the  New  York  City  Health 

Department "      .     220 

E.  Report   on   Information   gathered   at  the  Convention  of  the  Inter- 

national Milk  Inspectors  Association,  by  Clarence  E.  Marsh,  .     230 

F.  Digest  of  Recent  American  Milk  Legislation  by  Various  Cities  and 

States,  by  Dr.  Lewis  Fish,  .  .  233 


LIST  OF  APPENDICES. 


PAGE 

A.  —  Tabulation  of  Answers  to  Questionnaire  on  Milk  and  Disease  for  the 

Years  1909-13 238 

B.  —  Forms  of  Questionnaire  and  Letters  sent  to  Local  Boards  of  Health, 

and  a  List  of  Cities  and  Towns  failing  to  reply  to  Question- 
naire,         ..........  249 

C.  —  Abstract  of  Milk-borne  Epidemics  in  Massachusetts  from  1906-15,        .  252 

D.  —  Copy  of  Letter  sent  to,  and  replies  from,  Epidemiological  Authorities 

of  Other  States  relative  to  Milk  and  Disease,           .          .          .  262 

E.  —  Influence  of  Pasteurization  on  Chemical  ConteDt  of  Milk,    .          .          .  273 

F.  —  Status  of  Local  Milk  Inspection:  —  .          .          .          .          .          .          .  293 

(a)  Summary  of    Local   Milk   Inspection,    classified   by   Cities   and 

Towns, 297 

(6)  Summary  of  Local  Milk  Inspection,  alphabetically,    .          .          .  321 

G.  —  Statistics  of  Milk  Transportation  into  Boston,    .....  339 

H.  —  Replies  to  Questionnaire  relative  to  Local  Milk  Inspection,           .          .  344 

I.  —  Map  showing  Places  inspected  by  the  Milk  Board,       ....  353 

J.  —  Bibliography,           ..........  354 

K.  —  List  of  Conferences  and  Meetings  attended,  or  of  Persons  interviewed, 

relative  to  the  Milk  Question,        ......  356 


PREFACE. 


The  writer  became  Commissioner  of  Health  in  November, 
1914,  and  within  a  week  he  was  importuned  by  several  factors 
in  the  milk  problem  to  take  sides  and  give  testimony  for  or 
against  certain  proposed  legislation.  The  milk  problem  in 
Massachusetts  had  agitated  the  people  for  years,  and  had 
degenerated  into  an  acrimonious  controversy  which  made  it 
difficult  to  separate  easily  real  facts  from  mere  assertions. 

Milk  problems  exist  everywhere,  and  the  subject  was  not 
new  to  me  as  a  health  officer,  but  I  felt  that  conditions  in 
Massachusetts  were  different  from  other  States,  and  that  it 
would  be  unwise  and  unfair  to  apply  general  knowledge  of  a 
problem  without  a  careful  study  of  local  conditions  and  their 
bearing  on  the  problem.  I  felt  that  I  had  a  right  to  proceed 
one  year  at  least  under  existing  law,  and  to  utilize  that  time 
in  informing  myself  as  to  the  dairy  industry  in  Massachusetts. 

After  a  year's  study,  a  fair  impartial  report  with  recommen- 
dations could  be  made  from  facts  collected  by  an  unbiased 
board.  Accordingly,  I  appointed  a  Board  to  secure  the  facts 
in  the  dairy  industry  in  Massachusetts,  with  instructions  to 
extend  their  investigations  to  adjoining  States  and  the  Province 
of  Quebec.  I  knew  that  without  a  special  appropriation  this 
could  be  done  by  this  Department,  but  that  it  would  involve 
much  overtime  work  and  considerable  self-sacrifice  on  the  part 
of  the  Board.    The  personnel  of  the  Board  was  as  follows:  — 

Dr.  Eugene  R.  Kelley,  Director  of  the  Division  of  Communicable  Dis- 
eases, formerly  Commissioner  of  Health  of  the  State  of  Washington,  and 
a  sanitarian  of  wide  experience. 

Mr.  Hermann  C.  Lythgoe,  Director  of  the  Division  of  Food  and  Drugs, 
in  charge  of  both  the  inspection  and  laboratory  work  of  the  Department 
in  connection  with  milk,  an  analyst  and  chemist  with  a  most  thorough 
knowledge  of  all  phases  of  the  milk  problem. 

Mr.  Edward  H.  Williams,  a  practical  farmer  and  dairyman,  an  assistant 
in  the  Division  of  Sanitary  Engineering  of  the  Department,  who  was 


10 

selected  because  of  his  knowledge  of  farming  conditions  in  the  State,  and 
especially  with  those  conditions  related  to  or  dependent  upon  the  milk 
industry. 

As  a  representative  of  the  Public  Health  Council,  Dr.  J.  E.  Lamoureux 
was  appointed,  a  practicing  physician  of  high  standing,  an  excellent  sani- 
tarian, and  the  possessor  of  an  analytical  and  judicial  mind. 

These  gentlemen  worked  overtime,  Sundays  and  holidays, 
and  sacrificed  vacations  and  other  privileges,  in  order  to  carry 
on  the  work,  but  returned  with  all  the  available  data  touching 
our  milk  problem.  With  such  a  committee  I  feel  sure  not  only 
that  we  have  the  facts,  but  that  they  are  presented  fairly  with- 
out bias,  and  with  only  one  object,  viz.:  to  furnish  a  solution 
for  the  milk  problem  and  to  take  it  out  of  politics  and  out  of 
controversy  for  all  time. 


REPOET  OF  SPECIAL  MILK  BOARD  OF  THE  MASSA- 
CHUSETTS STATE  DEPARTMENT  OF  HEALTH. 


INTRODUCTION. 

The  special  Milk  Board  of  the  State  Health  Department 
was  appointed  by  the  State  Commissioner  of  Health  on  March 
29,  1915.  It  was  charged  with  the  duty  of  collecting  all  avail- 
able facts  relative  to  the  milk  problem  of  this  Commonwealth 
for  the  guidance  of  the  Commissioner  and  Public  Health  Coun- 
cil in  drafting  legislation  to  be  submitted  to  the  General  Court 
if  it  should  appear  from  the  results  of  such  investigation  that 
new  legislation  was  desirable. 

Originally  it  was  intended  to  confine  this  investigation  to  the 
public  health  aspects  of  milk  production  and  distribution. 
Because  of  the  closely  interwoven  connection  between  the 
economic  and  sanitary  features  of  the  milk  problem  your  Board 
soon  found  that  such  a  procedure  was  impossible,  and  we  have, 
therefore,  endeavored  to  cover  the  entire  problem  in  a  com- 
prehensive manner. 

The  report  is  seriously  incomplete  from  one  important  stand- 
point, —  the  total  number  of  producing  dairies  personally 
visited  by  members  of  your  Board.  We  estimate  that  in  all  we 
have  seen  possibly  2  per  cent,  of  the  producing  farms  supplying 
milk  to  Massachusetts  consumers.  As  far  as  possible  we  have 
endeavored  to  select  typical  sections,  and  feel  that  in  reality  we 
have  by  this  procedure  obtained  a  much  truer  picture  of  aver- 
age dairy  conditions  than  if  we  had  concentrated  our  visits  in  a 
smaller  area  and  possibly  visited  a  considerably  higher  per- 
centage of  the  total  producing  dairies. 

The  report  has  become  voluminous  under  our  hands  to  a 
degree  neither  anticipated  nor  desired,  but  the  entire  problem 
presents  so  many  ramifications  that  we  felt  we  could  not  in 


12 

justice  to  the  question  omit  any  of  the  included  subject-matter. 
In  fact,  many  bulky  sections  of  the  report  are  in  reality  very 
condensed  abstracts  of  the  total  data  consulted. 

Throughout  the  progress  of  the  report  your  Board  has  been 
indebted  to  the  courteous  co-operation  of  many  officials  and 
private  citizens.  A  partial  list  of  these  persons  is  given  in 
Appendix  K,  and  we  will  not  attempt  to  enumerate  them  all 
here. 

Special  mention  should  be  made,  however,  of  the  assistance 
given  by  the  personnel  of  the  Food  and  Drug  Division  of  the 
State  Department  of  Health,  including  both  inspectors,  ana- 
lysts and  clerical  force.  To  them  we  owe  the  collection  of  data 
from  local  boards  of  health. 

Two  of  the  State  district  health  officers,  Dr.  Lewis  Fish  and 
Dr.  John  S.  Hitchcock,  have  in  effect  served  as  members  of 
the  Board.  Several  sections  of  the  report  have  been  contrib- 
uted by  them,  and  they  have,  in  addition,  carried  out  pains- 
taking investigations  into  the  general  literature  of  milk  and  the 
epidemiological  records  of  this  Department.  Other  district 
health  officers,  notably  Dr.  Jones,  have  assisted  your  Board  in 
carrying  out  dairy  inspections. 

To  many  city  and  town  health  officials  within  the  Common- 
wealth, as  well  as  to  epidemiological  authorities  of  other  States, 
and  of  the  Federal  Public  Health  Service,  we  are  deeply  indebted 
for  valuable  information,  suggestions  and  criticisms. 

Special  acknowledgment  is  due  the  following  for  careful 
criticism  of  various  finished  sections  of  the  report :  — 

Dr.  Charles  V.  Chapin,  Superintendent  of  Health  of  Providence, 
R.I. 

Dr.  Mark  W.  Richardson,  Former  Secretary,  Massachusetts  State 
Board  of  Health. 

Dr.  Thomas  B.  Shea,  Director,  Division  of  Communicable  Diseases, 
Boston  City  Health  Department. 

Dr.  A.  J.  Chesley,  Director,  Division  of  Preventable  Diseases,.  Minne- 
sota State  Board  of  Health. 

All  of  these  gentlemen  critically  reviewed  Part  V.  of  the 
report  as  to  authenticity,  fairness  and  reasonableness  of  the 
epidemiological  deductions  contained  therein. 


13 

In  a  similar  manner,  special  acknowledgment  is  due  the 
following  gentlemen :  — 

Hon.  Wilfrid  Wheeler,  Secretary,  State  Board  of  Agriculture. 

Mr.  J.  C.  Orcutt,  Assistant  Secretary,  Boston  Chamber  of  Commerce. 

Mr.  P.  M.  Harwood,  Agent  of  the  State  Dairy  Bureau. 

Hon.  Chas.  M.  Gardner,  Member  of  State  Dairy  Bureau. 

Hon.  William  D.  T.  Trefry,  State  Tax  Commissioner. 

These  gentlemen  all  contributed  many  facts  and  statistics 
relative  to  present  and  past  production  of  milk. 

ABSTRACT  OF  REPORT  OF  MILK  BOARD. 

The  progress  of  this  investigation  revealed  such  a  mass  of 
facts  and  opinions  bearing  upon  the  present  milk  problem  of 
Massachusetts  that  the  inclusion  of  simply  the  most  pertinent 
material  made  this  report  voluminous  to  an  extent  not  antici- 
pated. We  have  therefore  deemed  it  wise,  for  the  benefit  of 
those  who  do  not  care  to  go  into  the  detail  of  the  subject,  to 
prepare  a  brief  abstract  of  the  report  for  inclusion  at  this 
point. 

The  report  is  divided  into  conclusions,  the  main  body  of  the 
report  and  appendices.  The  conclusions,  which  immediately 
follow  this  abstract,  cannot  be  further  summarized.  The  report 
proper  is  divided  into  seven  parts. 

PART  I. 
Section  A. 

In  this  section  it  is  first  pointed  out  that  there  has  been 
friction  between  the  producers,  middlemen  and  transportation 
interests  for  at  least  twenty  years.  In  addition  to  this  source  of 
irritation  such  things  as  overlapping  laws,  imposing  practically 
the  same  powers  and  duties  upon  the  State  Boards  of  Health 
and  Agriculture  and  local  boards  of  health,  overlapping  and  at 
times  contradictory  systems  of  dairy  inspections  by  State  and 
local  health  officials,  extreme  statements  from  all  parties  con- 
cerned as  to  the  relative  weight  of  different  sanitary  and  eco- 
nomic  aspects   of  the   problem,   have   all   contributed  to   the 


14 

development  of  the  bitter  controversial  spirit  that  has  been  so 
widely  manifested  relative  to  the  entire  subject  of  production 
and  sanitary  supervision  of  milk  in  the  Commonwealth  during 
the  past  six  years. 

Section  B. 

Three  special  investigations,  two  legislative  and  .one  non- 
official  (that  of  the  Boston  Chamber  of  Commerce),  have  added 
materially  to  the  information  available  upon  the  subject,  but 
cannot  be  said  to  have  produced  any  definite  results  except  the 
introduction  of  much  proposed  legislation  into  the  General 
Court. 

Section  C. 

The  laws  proposed  for  the  solution  of  the  milk  problem  of 
the  Commonwealth  are  in  general  agreement  in  providing  for 
the  abolition  of  certain  features  of  the  present  system  of  local 
control  and  the  substitution  of  a  central  State  inspection  board 
with  plenary  powers.  The  controversies  have  all  arisen  over 
the  manner  in  which  such  central  board  shall  be  appointed 
and  controlled. 

Section  D. 

It  is  not  possible  to  summarize  this  section  any  further. 

PART  II. 

In  this  part  an  attempt  has  been  made  to  gather  author- 
itative statements  from  various  persons  and  interests  con- 
cerned in  the  milk  question.  In  general,  these  may  be  said  to 
fall  into  three  groups. 

Group  A.  —  Dairy  and  agricultural  interests,  comprising  the  State 
Grange,  the  State  Board  of  Agriculture,  the  State  Department  of  Animal 
Industry  and  the  cattle  breeders'  associations. 

Group  B.  —  Those  concerned  in  the  business  aspects  of  the  question, 
viz.,  the  milk  dealers  and  the  Boston  Chamber  of  Commerce. 

Group  C.  —  Those  interested  in  milk  from  the  health  standpoint, 
viz.,  the  Milk  Consumers'  League,  the  Boston  Department  of  Health 
and  the  Milk  and  Baby  Hygiene  Associations. 

The  general  contention  of  Group  A  is  that  agitation  and  at- 
tempted legislation  have  had  only  detrimental   effect  on  the 


15 

milk  industry.  Natural  economic  conditions,  such  as  increase 
in  land  values,  increase  in  transportation  facilities,  and  more 
remunerative  returns  from  other  lines  of  agriculture  have  tended 
to  drive  milk  production  out  of  the  State.  In  addition  to  this 
there  is  a  general  feeling  that  the  attitude  and  statements  of 
the  so-called  clean  milk  advocates  has  had  a  positive  detrimen- 
tal influence  on  the  milk  business,  and  has  hastened  the  opera- 
tion of  these  economic  conditions.  This  group  offers  no  re- 
medial suggestions.  The  cattle  breeders'  associations,  with  the 
exception  of  the  Holstein  Breeders  Association,  in  answer  to 
a  direct  question  submitted  by  your  Board,  believe  that  the 
price  of  milk  should  be  governed  by  the  fat  content.  The 
Grange  believes  that  the  farmers  can  and  will  produce  a  better 
article  if  they  receive  a  better  price. 

The  general  contention  of  Group  B  is  that  the  present  sys- 
tem of  distribution  of  milk  cannot  be  greatly  improved  upon, 
but  that  the  competition  between  retail  dealers  is  disastrous  to 
the  financial  aspects  of  the  business,  and  the  lack  of  a  standard- 
ized or  graded  product  does  not  tend  to  improve  the  situation. 
Some  of  this  group  seem  to  be  of  the  opinion  that  official  in- 
spection should  be  centralized,  and  should  be  administered 
preferably  by  the  State  Department  of  Health. 

In  some  respects  the  members  of  Group  C  are  in  accord  with 
some  of  the  contentions  of  Group  B.  The  Health  Department 
of  the  city  of  Boston  believes  that  the  city  is  being  very  un- 
justly practically  forced  to  carry  nearly  all  the  expense  inci- 
dental to  milk  inspection  for  most  of  the  other  cities  and  towns 
comprising  greater  Boston,  and  for  this  reason  are  strongly  in 
favor  of  this  duty  being  transferred  to  some  State  authority. 
The  Massachusetts  Milk  Consumers'  League,  to  use  their  own 
words,  state:  "The  Association  has  never  taken  any  arbitrary 
position  as  to  the  form  of  the  bill,  only  insisting  on  the  central 
principle  that  the  State  Department  of  Health  should  have 
legal  power  on  its  own  initiative  in  places  where  milk  is  pro- 
duced or  handled,  to  insist  upon  reasonable  cleanliness." 


16 

PART  III. 
Section  A. 

As  this  section  is  itself  merely  a  summary  of  the  conditions 
noted  in  the  various  trips  of  inspection  made  by  the  members 
of  the  Milk  Board,  it  is  difficult  to  emphasize  its  findings  any 
further,  but  the  general  impression  received  was,  although 
many  individual  and  geographical  exceptions  to  the  rule  were 
found,  that  producing  dairies  in  Massachusetts  were,  on  the 
whole,  in  very  satisfactory  sanitary  condition,  which  impres- 
sion is  substantiated  by  the  records  of  routine  dairy  inspec- 
tions made  by  the  State  Department  of  Health.  Typical 
dairies  in  Maine,  New  Hampshire,  Vermont  and  Quebec  sup- 
plying Massachusetts  markets  are,  on  the  whole,  somewhat 
below  the  sanitary  standards  of  Massachusetts  dairies. 

Section  B. 

This  section  is  a  portion  of  the  summary  of  replies  received 
to  a  questionnaire  submitted  to  contractors.  It  deals  with  the 
phases  of  production  and  of  distribution  of  their  milk  supply 
and  gives  a  summary  of  their  methods  of  dairy  inspection. 

Section  C. 

This  section  deals  with  the  production  of  milk  in  Massa- 
chusetts and  neighboring  States  and  the  province  of  Quebec, 
and  its  increase,  decrease  and  geographical  fluctuations.  Milk 
production  in  Massachusetts  has  steadily  decreased  while  the 
population  has  increased.  In  this  section  the  following  points 
are  discussed:  variation  in  number  of  milch  cattle  kept  in 
Massachusetts  from  1890  to  date,  supplemented  by  evidence  of 
freight  statistics  of  the  milk  brought  into  greater  Boston; 
effects  of  the  increasing  cost  of  producing  milk  in  Massachu- 
setts, and  its  comparison  with  the  cost  of  milk  production  in 
other  States  and  Quebec;  the  relative  importance  of  dairying 
to  diversified  farming;  the  fact  that  beside  the  use  of  milk  raw 
and  for  cooking  purposes  the  steadily  increasing  consumption 
of  cream,  butter,  cheese  and  ice  cream  accounts  for  a  large 
proportion  of  the  total  milk  consumed;  the  use  of  the  by- 
products of  milk,  particularly  of  casein  in  the  arts  and  sciences, 


17 

and  the  fact  that  this  is  a  relatively  unappreciated  but  im- 
portant use  of  cow's  milk;  causes  assigned  by  various  inter- 
ested parties  for  the  decrease  in  milk  production,  the  principal 
ones  alleged  being  oppressive  activities  of  the  State  and  local 
boards  of  health  in  carrying  out  dairy  inspection,  the  exag- 
gerated newspaper  publicity  relative  to  milk  epidemics  and 
alleged  epidemics,  constant  legislative  agitation,  the  increasing 
use  of  evaporated,  powdered  and  condensed  milks  brought  in 
from  long  distances,  lower  prices  offered  to  the  producer,  the 
development  of  more  remunerative  and  less  laborious  forms  of 
agriculture,  together  with  increasing  scarcity  of  farm  labor; 
several  pages  are  devoted  to  the  actual  cost  of  keeping  cows 
and  producing  milk,  according  to  best  statistics  available;  the 
average  amount  of  milk  production  per  cow  in  Massachusetts 
and  neighboring  States;  salient  points  obtained  by  interviews 
with  agents  of  condensed,  powdered  and  evaporated  milk 
companies. 

This  section  closes  with  general  comments  on  milk  produc- 
tion and  the  importance  of  producing  more  milk  and  the  value 
to  the  Commonwealth  of  the  dairy  industry. 

Section  D. 

In  this  section  the  influence  of  heat  upon  milk  is  discussed. 
The  process  of  commercial  pasteurization  as  carried  out  in  this 
State  is  without  apparent  influence  upon  the  chemical  composi- 
tion of  milk.  Experiments  made  in  the  commercial  pasteurizing 
plants  show  that  the  process  as  applied  is  very  efficient  in 
lowering  the  bacterial  content,  but  owing  to  possible  reinfec- 
tion the  health  authorities  should  control  the  operation  of  these 
plants. 

PART  IV. 

Section  A. 

In  this  section  is  given  a  summary  of  the  activities  of  the 
various  bodies  engaged  in  the  official  supervision  of  Massachu- 
setts milk,  and  a  digest  of  the  laws  under  which  they  work. 
This  work  is  carried  on  by  local  boards  of  health,  the  State 
Department  of  Health,  the  Dairy  Bureau  of  the  State  Board 
of  Agriculture,  the  State  Department  of  Animal  Industry,  and 
the  United  States  Department  of  Agriculture.      Local  boards 


18 

of  health  are  given  authority  to  grant  licenses,  inspect  dairies, 
take  samples  for  analysis,  and  to  make  and  enforce  rules  and 
regulations.  In  general  they  have  unlimited  powers  to  ade- 
quately supervise  and  control  the  milk  supply  of  their  respec- 
tive cities  or  towns.  The  State  Department  of  Health  and  the 
Dairy  Bureau  have  power  to  collect  samples  and  to  enforce  the 
laws  relative  to  the  adulteration  of  milk.  The  State  Depart- 
ment of  Animal  Industry  exercises  a  certain  amount  of  control 
over  the  health  of  cattle  by  an  annual  inspection  made  by  the 
local  inspector  of  animals. 

Section  B. 

A  special  study  has  been  made  of  the  operation  of  local  milk 
inspection  from  which  it  has  been  ascertained  that  about 
20  per  cent,  of  the  total  population  received  no  protection 
relative  to  milk  from  their  local  boards  of  health.  The  balance 
received  some  protection,  but  only  43  per  cent,  are  adequately 
protected.  If  Boston  is  excluded  from  the  list,  25  per  cent,  of 
the  balance  of  the  population  receive  no  protection,  and  only 
28  per  cent,  are  adequately  protected  from  possible  dangers 
arising  from  the  milk  supply. 

Section  C. 

In  this  section  the  present  system  of  dairy  inspection  is  dis- 
cussed in  relation  to  its  sanitary  value.  Although  in  many 
instances  too  much  importance  has  been  attached  to  the  condi- 
tion of  the  dairy  and  too  little  to  the  condition  of  the  milk, 
the  dairy  inspection  as  carried  out  in  the  past  has  resulted  in 
an  improvement  in  our  milk  supply. 

PART  V. 
Section  A. 
It  is  not  possible  to  summarize  this  section  any  further. 

Section  B. 

A  number  of  the  human  communicable  diseases  are  trans- 
mitted through  milk.    Those  of  the  most  importance  in  Massa- 


19 

chusetts  are  tuberculosis,  diphtheria,  scarlet  fever,  septic  sore 
throat  and  typhoid  fever. 

In  tuberculosis  the  milk  may  be  infected  by  the  cow  pro- 
ducing it  or  by  the  human  beings  who  handle  it. 

In  the  other  four  diseases  mentioned,  except  possibly  in  the 
case  of  scarlet  fever,  the  infection  does  not  originate  in  the 
cow;    the  source  is  in  the  human  handlers. 

The  amount  of  communicable  disease  transmission  through 
cow's  milk  has  been  overestimated,  but  such  transmission  does 
occur  in  a  degree  of  frequency  which  demands  public  protection. 

The  infection  of  milk  with  human  disease  germs  may  occur 
at  any  time  between  its  secretion  in  the  cow  and  its  con- 
sumption. 

In  addition  to  infection  with  human  disease  germs  milk  may 
be  otherwise  polluted,  or  may  decay  to  a  degree  that  renders  it 
an  unsafe  food  for  human  beings. 

To  insure  its  safety  as  a  human  food  two  procedures  of 
control  are  necessary. 

First.  —  By  inspection  of  cattle,  methods  of  production  and 
transportation,  secure  a  supply  that  is  pure,  clean  and  fresh. 

Second.  —  By  the  application  of  heat  destroy  all  disease 
germs  that  may  be  in  it,  whether  they  come  from  animal  or 
human  sources. 

There  are  two  methods  of  disinfection  by  heat  in  common 
use:  (a)  complete  sterilization  by  boiling;  (b)  partial  steriliza- 
tion—  "pasteurization" — by  heating  the  milk  to  between 
140°  and  150°  F.  for  from  twenty  to  thirty  minutes. 

Both  of  these  methods  are  effective. 

The  partial  sterilization  —  "pasteurization"  —  seems  to  have 
fewer  objectionable  features,  and  is  already  established  in  this 
country  as  an  accepted,  successful  process. 

To  obtain  the  most  perfect  results,  market  milk,  intended  for 
human  consumption  as  milk,  should  be  pasteurized  under  the 
control  of  the  health  authorities. 

Section  C. 

The  infant  mortality  rate  is  still  higher  than  it  should  be,  — 
higher  than  investigators  feel  is  inevitable.  A  still  undeter- 
mined part  of  this  excess  is  due  to  the  quality  of  infant's  food 


20 


and  the  method  of  its  administration.  Breast  milk  is  the 
natural  food  for  the  infant.  When  this  maternal  function  fails 
a  substitute  food  is  required.  Modified  cow's  milk  is  the  com- 
mon substitute,  although  it  has  inherent  qualities  that  make  it 
an  imperfect  food  for  infants.  The  supply  for  our  cities  must 
be  brought  from  a  distance.  It  may  become  polluted  at  any 
time  between  its  secretion  in  the  cow's  udder  and  its  digestion 
in  the  stomach  of  the  infant.  To  make  it  reasonably  safe  it 
should  be  controlled  by  inspection  and  pasteurization  up  to 
the  point  of  delivery  at  the  home,  and  controlled  after  delivery 
by  the  education  of  the  mother  in  hygienic  methods. 

Section  D. 

The  exceptional  place  of  milk  as  the  indispensable  food  for 
infants  and  invalids  is  emphasized.  The  fact  that  milk  is  a 
unique  food  in  the  sense  of  being  so  complete  in  itself  that  it 
can  sustain  life  alone  for  indefinite  periods  is  emphasized;  also 
that  it  is  in  food  value  one  of  the  cheapest  of  foods.  Under 
our  present  conditions  there  is  a  great  economic  waste  of  a 
part  of  the  milk  that  has  in  itself  a  high  nutritious  value,  — 
that  is  to  say,  the  skimmed  milk. 

PART  VI. 
Section  A. 

In  this  section  the  subject  of  grading  is  discussed,  both  from 
the  bacteriological  standpoint  and  from  the  standpoints  of  per- 
centage composition  and  of  food  values.  The  average  milk 
sold  in  Massachusetts,  although  considerably  above  the  stand- 
ard, is  nevertheless  steadily  becoming  more  inferior  in  fat,  the 
average  of  which  in  1909  was  4.10  per  cent.,  and  in  1915  had 
been  reduced  to  3.82  per  cent.  The  New  York  system  of 
bacteriological  control  and  its  application  is  discussed.  The 
commercial  pasteurization  of  milk  should  be  under  official  con- 
trol, which  is  not  the  case  at  present  in  Massachusetts,  and  if 
this  were  done  the  pasteurization  of  dirty  milk,  or  of  milk  high 
in  bacteria,  could  be  prohibited.  A  premium  should  be  paid 
for  milk  low  in  bacteria  as  well  as  for  milk  high  in  fat. 


21 


Section  B. 

A  special  article  is  inserted  in  this  section  showing  the  rela- 
tion between  the  solids  and  fat  in  known  purity  and  commer- 
cial milk.  It  is  evident  from  a  study  of  the  charts  introduced 
that  commercial  milk  is  somewhat  deficient  in  fat.  The  intro- 
duction of  a  grading  system  by  which  milk  may  be  sold  on  its 
fat  percentage  would  stop  this  form  of  adulteration,  which, 
while  too  slight  to  be  proven  in  a  court  of  law,  yet  is  sufficient 
to  be  apparent  when  the  averages  are  compared  with  data 
obtained  from  milk  of  known  purity. 

PART  VII. 

In  this  part  the  experiences  of  other  localities  is  discussed. 
Section  A  is  a  special  report  on  the  New  York  City  grading 
system  from  investigations  made  in  the  city  of  New  York. 
Sections  B  and  C  are  special  reports  on  the  efficiency  of  the 
system  in  the  producing  area.  Section  D  is  a  special  article 
upon  this  system  by  Lucius  P.  Brown,  Chief  of  the  Food  Divi- 
sion, New  York  City  Department  of  Health.  This  system  has 
been  studied  to  the  best  of  our  ability,  visits  being  made  to 
the  New  York  City  Health  Department,  th*e  New  York  State 
Department  of  Health,  several  New  York  milk  dealers,  one 
commercial  chemicaj  laboratory  in  New  York  City,  to  the 
producing  territory  and  to  one  country  pasteurizing  station  in 
Connecticut.  Every  definite  complaint  relative  to  the  ineffi- 
ciency of  this  system  brought  to  our  attention  has  been  care- 
fully investigated,  and  in  all  cases  these  complaints  have  been 
found  to  be  without  foundation.  The  system  is  substantially 
as  follows :  — 

All  milk  except  of  a  quality  resembling  certified  milk  must 
be  pasteurized.  If  the  bacteria  content  is  high  before  pasteur- 
ization it  must  be  labeled  "Grade  C,  For  Cooking  Purposes 
Only."  There  are  two  other  grades  of  pasteurized  milk, 
"Grade  A  Pasteurized"  and  "Grade  B  Pasteurized."  The 
Grade  A  milk  is  obtained  from  better  stables,  and  has  a  lower 
bacteria  content  before  pasteurization  than  Grade  B  milk. 
Section  E  gives  a  report  of  information  regarding  the  experience 


22 

of  other  localities  gathered  at  the  Convention  of  Milk  and 
Dairy  Inspectors  in  Washington,  D.  C,  from  conversation 
with  the  milk  inspectors  of  various  cities  and  towns  of  the 
United  States.     This  report  cannot  be  further  summarized. 

In  Section  F  is  given  an  abstract  of  the  laws  and  regulations 
relative  to  milk  in  force  in  various  States  and  municipalities  in 
the  United  States.  This  report  is  of  such  nature  that  it  cannot 
be  further  abstracted. 

CONCLUSIONS . 

Cow's  milk  is  an  invaluable  article  of  diet. 

In  the  interest  of  the  public  health  its  use  as  a  food  should 
be  maintained  and  extended. 

Healthy  animals  and  proper  methods  are  more  important 
than  equipment  in  the  production  of  clean,  wholesome  milk. 

Epidemics  of  disease  have  not  infrequently  been  caused  by 
raw  milk,  but  the  amount  of  communicable  disease  so  trans- 
mitted is  much  less  than  has  been  often  asserted. 

Pasteurization. 

Pasteurization  or  sterilization  is  the  only  practical  method 
for  insuring  the  safety  of  commercial  milk. 

No  epidemic  has  ever  been  traced  with  certainty  to  pas- 
teurized milk. 

The  present  uncontrolled  method  of  pasteurization  does  not 
furnish  a  satisfactory  safeguard  to  the  public. 

To  make  certain  of  the  adequacy  of  the  processes  of  steriliza- 
tion or  pasteurization,  the  responsibility  therefor  should  rest 
upon  public  health  officials*. 

Employees  in  commercial  pasteurizing  plants  should  be  sub- 
jected to  routine  physical  examination. 

Pasteurization  should  not  be  allowed  to  be  used  to  conceal 
an  inferior  quality  of  milk. 

Milk  in  the  Possession  of  the  Consumer. 

Fresh  milk  has  a  greater  food  value  than  other  milk. 

Milk,  while  in  the  possession  of  the  consumer,  should  be  no 
less  scrupulously  cared  for  than  while  in  the  hand  of  the  producer 
or  dealer. 


23 

(a)  It  should  be  immediately  placed  in  a  cool  place  and  kept 
there,  duly  protected,  until  used. 

(b)  All  milk  bottles  received  by  the  consumer  should  be 
washed  with  soap  and  hot  water  as  soon  as  the  milk  has  been 
removed,  and  should  be  kept  clean  until  returned  to  the  dealer. 

(c)  Milk  bottles  should  never  be  used  for  anything  but  milk, 
as  is  provided  for  by  statute. 

Tuberculosis. 

In  addition  to  epidemic  diseases,  the  evidence  is  now  con- 
clusive that  a  very  considerable  proportion  of  tuberculosis  in 
children  is  due  to  infection  by  the  bovine  type  of  tubercle 
bacilli  taken  into  the  body  by  drinking  raw  milk. 

Bovine  tuberculosis  is  prevalent  to  a  dangerous  degree  in 
ordinary  dairy  herds. 

Dairymen  should  attempt  to  eradicate  tuberculosis  from 
their  herds,  not  only  in  the  interest  of  public  health,  but  also 
to  improve  the  quality  of  their  young  stock. 

Adequate  pasteurization  as  effectively  destroys  tubercle 
bacilli  as  it  does  the  germs  of  epidemic  diseases. 

Milk  for  Infant  Feeding. 

Cow's  milk  is  decidedly  inferior  to  mother's  milk  as  a  food 
for  infants,  but  clean  cow's  milk  is  the  best  as  well  as  the  most 
common  substitute  for  mother's  milk. 

Some  part  of  our  excessively  high  infant  mortality  rate  is 
probably  due  to  unwholesome  qualities  of  the  cow's  milk 
furnished  to  infants.  It  is  generally  admitted,  however,  at 
present,  by  children's  specialists  and  sanitarians,  that  the  use 
of  cow's  milk  regardless  of  quality  furnishes  only  one  among 
many  factors  in  the  total  causes  of  infant  mortality. 

There  appear  to  be  some  grounds  for  concluding  that  in  some 
cities  of  this  Commonwealth  the  inadequacy  of  the  total  sup- 
ply of  cow's  milk  for  infants  and  young  children  is  a  more 
serious  public  health  problem  than  any  existing  deficiencies  in 
quality. 


24 


Existing  Inspection. 

The  present  laws  for  the  supervision  of  milk  production  and 
distribution  in  Massachusetts  give  ample  authority  to  the 
cities  and  towns  to  protect  their  milk  supplies  in  as  stringent 
and  thorough  a  fashion  as  they  may  see  fit. 

These  laws  make  it  mandatory  upon  cities  and  towns  to 
carry  out  thorough  dairy  inspection  in  all  dairies  supplying 
milk  for  their  consumption. 

The  present  system  of  sanitary  supervision  of  milk  by  local 
authorities  is  in  the  •  aggregate  costing  the  people  of  the  Com- 
monwealth fully  as  much  if  not  more  than  a  complete,  well- 
balanced,  uniform  system  of  control. 

As  these  laws  are  carried  out  the  practical  results  are  (1) 
that  the  inhabitants  of  many  cities  and  towns  receive  no  pro- 
tection whatsoever,  and  the  inhabitants  of  many  other  cities 
and  towns  receive  protection  at  the  expense  of  the  taxpayers 
in  neighboring  cities;  (2)  responsibility  is  divided,  official 
friction  between  cities  and  towns  is  incurred;  (3)  the  literal 
carrying  out  of  the  laws  would  result  in  an  inconceivable  mass 
of  overlapping  inspections;  (4)  the  producer  not  having  a  fixed 
standard,  owing  to  the  changing  and  contradictory  orders  of 
local  milk  inspectors,  is  confused  and  discouraged. 

State  Control. 

There  is  no  law  at  present  providing  for  State  control  of  the 
milk  supply  of  this  Commonwealth  relative  to  the  public 
health. 

The  systematic  dairy  inspections  instituted  in  this  State  by 
the  State  Board  of  Health,  and  subsequently  carried  on  by 
local  authorities,  have  been  productive  of  improved  dairy  condi- 
tions and  an  improved  milk  supply,  many  producers  having 
taken  advantage  of  the  opportunities  of  obtaining  valuable 
information  from  the  inspectors. 

The  clean  milk  contests  of  the  State  Board  of  Agriculture 
have  been  productive  of  much  good  among  those  producers 
who  distribute  milk  of  their  own  production  direct  to  the 
consumer. 


25 

Milk  production  should  be  so  supervised  as  to  result  in  a 
maximum  of  cleanliness  and  safety  with  a  minimum  of  inter- 
ference with  the  milk  industry. 

Sale  of  Milk.     Prices. 

At  the  present  prices,  or  even  at  considerably  higher  prices 
than  those  prevailing  at  present,  milk  is  one  of  the  most 
economical  of  foods. 

There  are  no  reasonable  grounds  for  believing  that  the  retail 
price  of  milk  can  be  lowered. 

Milk  should  be  bought  and  sold  on  its  merits  as  determined 
by  its  chemical  and  bacteriological  condition  rather  than  by 
volume  only.  This  should  include  higher  price  for  higher  fat 
content  and  higher  price  for  low  bacterial  content. 

Massachusetts  Dairies. 

Massachusetts  dairymen  must  produce  milk  of  a  superior 
quality  if  they  are  to  hold  the  confidence  and  patronage  of  the 
consumers  of  the  Commonwealth. 

As  far  as  statistics  are  available  it  would  appear  that  Massa- 
chusetts dairymen  produce  more  milk  per  cow  than  dairymen 
of  neighboring  States  and  countries,  and  produce  it  under  gen- 
erally better  conditions  as  to  cleanliness. 

Nevertheless,  milk  production  in  Massachusetts  has  rapidly 
decreased  since  1890. 

To  supply  the  steadily  increasing  population  of  the  State 
with  milk  and  cream,  the  large  dealers  of  Boston  and  other 
cities  have  been  going  to  points  in  other  States  (principally 
Maine,  Vermont  and  New  Hampshire)  and  the'  province  of 
Quebec  to  secure  adequate  supply. 

The  great  distance  of  some  of  these  points,  together  with 
careless  handling  and  slow  transportation,  tends  to  place  a 
large  amount  of  milk  on  the  Massachusetts  market  which  is 
less  desirable  than  milk  produced  near  by. 

Sufficient  milk  to  supply  Massachusetts  people  could  be  pro- 
duced within  the  borders  of  the  State  if  the  thousands  of  acres 
of  naturally  good  dairy  lands  now  lying  idle  were  stocked  with 
milch  cattle. 


26 

The  principal  reason  for  the  decline  in  dairying  in  this  State 
is  the  low  price  paid  to  producers. 

Other  causes  are  the  increase  in  the  cost  of  cows,  grain, 
building  materials,  labor  and  the  improved  methods  demanded 
by  State  and  municipal  authorities,  as  well  as  constant  legis- 
lative agitation  for  several  years. 

Milk  can  be  bought  at  lower  prices  at  out-of-State  points 
than  Massachusetts  farmers  can  produce  it  with  profit. 

Milk  transportation  rates  are  lower  in  proportion  for  long 
haul  than  for  short  haul. 

Massachusetts  dairymen  have  been  in  general  subjected  to 
a  more  rigid  enforcement  of  dairy  rules  and  regulations  than 
out-of-State  producers  of  milk. 

Massachusetts  dairymen  furnishing  milk  for  near-by  con- 
sumption must  compete  with  an  inferior  grade  of  milk  pro- 
duced out  of  State,  which  has  been  freed  from  disease  germs 
by  pasteurization,  and  has  been  rendered  macroscopically 
acceptable  to  the  consumer  by  clarifying  processes  to  remove 
filth  originally  introduced  by  slovenly  dairy  methods. 

Owing  to  the  fact  that  in  Massachusetts  there  are  scarcely 
any  country-receiving  milk  stations,  milk  produced  in  Massa- 
chusetts must  be  marketed  more  quickly  than  milk  produced 
out  of  State  which  has  been  clarified  and  pasteurized  before 
being  shipped. 

It  would  be  an  advantageous  practice  if  Massachusetts  dairy- 
men would  label  State-raised  milk  as  Massachusetts  Milk, 
particularly  if  a  State  authority  could,  after  examination, 
permit  its  sale  as  a  distinct  grade  of  milk. 


27 


PART  I.    HISTORICAL. 


A.    DEVELOPMENT  OF  PRESENT  MILK  CONTROVERSY. 

It  would  be  hard  to  say  when  the  milk  business  became  the 
subject  of  discussion  between  various  interests,  but  probably  at 
a  time  more  than  twenty  years  ago  it  became  a  subject  of  bitter 
controversy  between  producers  and  the  so-called  contractors; 
dairymen  claiming  that  they  were  not  paid  a  fair  price  for  milk, 
and  that  the  surplus  system  and  some  other  features  made  it 
an  absolutely  losing  proposition  to  produce  milk  to  be  sold  to 
the  large  dealers.  Complaints  were  numerous  of  the  methods 
employed  in  transportation.  The  many  ways  in  which  the 
farmers  had  been,  or  claimed  to  have  been,  defrauded,  either 
by  a  system  of  discounted  price  for  surplus  milk  or  by  the  fail- 
ure of  dealers  to  pay  for  the  milk,  added  to  the  confusion. 
Efforts  were  made  by  different  organizations,  either  of  Massa- 
chusetts or  New  England  dairymen,  to  eliminate  some  of  the 
troubles,  but  it  seems  that  they  were  not  successful,  as  we  hear 
the  same  complaints  to-day  about  the  price  of  milk  and  of 
transportation  methods.  So  bitter  were  the  controversies  be- 
tween the  producers  and  the  large  dealers  that  many  of  the 
dairymen  either  reduced  the  amount  of  milk  production  on 
their  places  or  went  out  of  business  altogether. 

On  the  other  hand,  the  contractors  have  claimed  that  the 
price  they  paid  was  all  that  was  possible,  when  the  cost  of 
handling  and  the  price  received  by  them  from  the  consumer 
were  taken  into  consideration,  and  they  have  always  claimed 
that  the  margin  of  profit  was  small.  Many  times  contractors 
have  claimed  that  no  satisfactory  adjustment  of  prices  could 
ever  be  made  until  the  consumer  was  willing  to  pay  more  for 
milk. 

The  question  of  transportation  is  still  under  discussion. 
Claims  are  made  by  different  dairymen  that  under  the  present 
system  of  handling  milk  on  the  railroads  they  cannot  market 
their  milk  to  the  best  advantage.  The  railroad  companies, 
principally  the  Boston  &  Maine,  have  claimed  that  there  was 


28 

no  profit,  and  many  times  a  loss,  in  the  transportation  of  milk, 
and  have  recently  asked  the  Public  Service  Commission  of 
Massachusetts  to  consent  to  an  increase  in  transportation 
rates. 

In  recent  years,  beginning  with  1906,  when  the  first  system- 
atic dairy  inspection  was  made  by  the  State  Board  of  Health, 
there  have  been  many  discussions  as  to  the  right  and  justice 
of  the  dairy  inspection  as  conducted  by  the  State  or  local 
boards  of  health.  Inspection  methods  have  received  a  great 
deal  of  criticism,  and  complaints  made  that  the  multiplicity 
of  inspections  has  tended  to  make  the  production  of  milk  a 
very  unsatisfactory  business.  The  positions  taken  by  certain 
health  authorities  and  prominent  social  workers  that  milk  was 
the  cause  of  much  disease  and  many  deaths  among  infants  of 
our  large  cities,  and  many  published  reports  of  cases  of  dis- 
eases and  deaths  caused  by  milk-borne  epidemics,  have  been 
assailed  by  many  dairymen  as  unjust  and  tending  to  harm  the 
business  to  such  a  degree  that  the  business  is  becoming  less 
profitable  on  this  account  as  well  as  on  account  of  the  activi- 
ties of  the  inspectors.  The  result  of  these  controversies  be- 
tween producers,  contractors,  health  authorities  and  organiza- 
tions has  been  the  introduction  of  legislative  bills  that  have 
generally  served  to  keep  up  the  constant  agitation. 

The  following  have  taken  more  or  less  active  part  in  the  dis- 
cussion of  milk  conditions  in  Massachusetts,  but  have  seemingly 
never  arrived  at  any  definite  conclusion  or  settlement  of  the 
situation:  The  Boston  Chamber  of  Commerce,  the  Grange, 
State  Board  of  Agriculture,  the  Department  of  Animal  Indus- 
try, Milk  Consumers'  League,  labor  organizations,  Milk  and 
Baby  Hygiene  Associations,  the  contractors,  medical  societies 
and  others. 

In  the  year  1912  efforts  were  made  to  bring  together  the 
State  Board  of  Health,  the  State  Board  of  Agriculture,  and  the 
executive  committee  of  the  Massachusetts  State  Grange  and 
various  dairymen,  so  that  there  might  be,  if  possible,  a  settle- 
ment of  some  of  the  difficulties  in  the  milk  business. 

The  local  milk  inspectors  have  generally  appeared  at  legisla- 
tive hearings,  and  have  taken  an  active  part  in  opposing  legis- 
lation tending  to  centralize  the  authority  of  milk  inspection; 


29 

but  up  to  the  present  time  there  has  never  been  any  legislation 
that  would  satisfy  all  of  the  parties  concerned,  and  the  future 
must  decide  how  this  vexatious  problem  can  be  fairly  adjusted. 

B.    EARLIER  INVESTIGATIONS. 

There  have  been  three  previous  investigations  of  the  milk 
situation  in  Massachusetts  carried  out  during  the  past  six 
years.     They  are  — 

(a)  The  investigation  into  the  cost  of  production,  transporta- 
tion and  marketing  of  milk  within  the  Commonwealth  by  a 
joint  special  committee  of  the  General  Court  of  1910. 

(6)  The  report  of  the  special  commission,  consisting  of  the 
members  of  the  Dairy  Bureau,  of  the  State  Board  of  Agricul- 
ture and  two  additional  members  appointed  by  the  Governor, 
authorized  by  a  resolve  of  the  General  Court  of  1910. 

(c)  The  report  of  the  special  committee  on  milk  of  the  Bos- 
ton Chamber  of  Commerce,  issued  in  July,  1915. 

Your  Board  has  made  a  careful  and  intensive  study  of  the 
subject-matter  of  these  three  reports,  and  as  far  as  they  have 
been  available  have  examined  the  original  data  upon  which 
these  reports  are  based. 

In  the  case  of  the  first  report,  through  the  courteous  co- 
operation of  the  Hon.  Charles  M.  Gardner,  a  member  of  this 
committee,  your  Board  has  had  access  to  and  has  thoroughly 
studied  for  several  months  past  the  verbatim  testimony  pre- 
sented at  the  numerous  hearings  of  this  committee. 

In  the  case  of  the  last  report,  through  the  courtesy  of  the 
officials  of  the  Boston  Chamber  of  Commerce,  especially  Mr. 
John  C.  Orcutt,  assistant  secretary  of  the  Chamber  of  Com- 
merce, in  charge  of  this  investigation,  your  Board  has  had 
access  to  practically  all  the  facts  upon  which  this  report  is 
based. 

In  the  case  of  the  second  investigation  in  the  introduction 
to  that  report  the  following  sentences  occur:  "The  first  step 
was  to  secure  and  place  on  file  for  reference  as  complete  data 
as  were  obtainable  from  every  State  which  has  a  system  of  milk 
inspection.  This  resulted  in  the  collection  of  a  vast  amount 
of  information  regarding  milk  inspection  and  handling.  All 
these  data  have  been  studied,  compiled  and  tabulated,  and  put 


30 

in  concise  form  for  future  reference."  Persistent  and  diligent 
inquiry  addressed  to  all  the  individual  members  of  this  Com- 
mission has  failed  up  to  the  present  to  unearth  any  of  these  data 
referred  to  for  our  enlightenment.  We  may  add  parenthetically 
that  this  striking  example  of  how  easily  valuable  data,  com- 
piled for  the  express  purpose  of  having  them  accessible  for  future 
reference,  become  completely  lost  to  sight  in  a  few  years'  time 
has  been  the  cause,  to  no  small  degree,  of  your  Board  adopting 
a  radically  different  policy  in  reference  to  the  data  that  we  have 
compiled.  We  feel  that  we  might  also  fairly  lay  claim  to  having 
accumulated  at  least  a  considerable  "amount  of  information," 
but  we  have  included  practically  all  of  it,  that  in  our  opinion 
has  any  direct  value  to  the  question  under  investigation,  in 
either  the  body  of  our  report  or  among  the  appendices. 

(a)    Abstract  of  the  Report  of  the  Special  Joint  Milk  Investi- 
gating Committee  of  the  General  Court  of  1910. 

This  committee  considered  themselves  limited,  by  the  terms 
of  the  order  creating  the  committee,  in  their  scope  of  inquiry 
to  "an  investigation  of  the  methods  and  costs  of  said  produc- 
tion, transportation  and  marketing." 

They  concluded  and  reported  essentially  as  follows :  — 

1.  That  milk  on  the  average  could  not  be  produced  in  1910 
in  Massachusetts  at  an  actual  cdst  to  the  producer  of  less  than 
4  cents  per  quart. 

2.  That  the  "control"  of  producers  by  the  "contractors" 
of  the  metropolitan  district  of  Boston  "tends  to  create  and 
maintain  a  monopoly  in  the  sale  of  milk,  and  to  restrain  com- 
petition in  the  supply  and  price  of  milk." 

3.  That  "the  cost  and  methods  of  transportation  are  of  great 
importance  to  the  consumer  as  affecting  not  only  the  cost  of 
milk  to  him,  but  also  its  freshness."  They  go  on  to  condemn 
the  "leased  car"  system  on  this  basis,  and  specifically  recom- 
mend repeal  of  certain  sections  of  the  (then)  transportation 
statutes,  and  the  substitution  therefor  of  the  "flat-rate  system." 

4.  That  there  was  no  definite  proof  of  any  collusion  between 
the  different  "contractors"  as  to  price  and  territory,  but  the 
committee,  on  the  contrary,  express  themselves  satisfied  that 
the  contractors  are  truly  competing  with  each  other,  and  also 


31 


that  the  contractors  are  making  a  fair  profit  on  their  invest- 
ment. 

5.  That  regular  and  adequate  sanitary  inspection  of  market 
milk  is  necessary  in  the  interests  of  the  public  health. 

6.  That  this  (i.e.,  work  of  milk  inspection)  cannot  be  properly 
and  economically  done  by  the  health  officers  of  the  several 
cities  and  towns.  It  should  be  done  by  some  central  authority. 
To  do  this  "requires  an  examination  of  existing  laws,  the  en- 
actment of  new,  and  the  repeal  or  modification  of  existing  laws 
which  would  consume  much  time."  They  then  recommend 
that  the  Dairy  Bureau  be  charged  with  the  duty  of  formulating 
a  general  bill  to  cover  these  points. 

This  report  was  signed  by  five  of  the  seven  members  of  the 
committee,  one  member  concurring  in  all  except  the  recommen- 
dation for  further  reference  to  the  Dairy  Bureau,  urging  the 
formulation  and  passage  of  immediate  corrective  legislation; 
one  other  member  concurring  in  the  minority  opinion,  and  also 
filing  an  opinion  that  the  joint  special  committee  itself  should 
have  recommended  specific  legislation  to  "remedy  the  abuses 
and  the  iniquities  of  the  present  transportation  system." 

(b)    Report  of  the  Committee  on  Inspection  of  Milk  of  1910. 

Following  the  recommendations  of  the  special  joint  committee 
on  milk  of  the  General  Court,  a  resolve  was  passed  directing 
the  Dairy  Bureau  of  the  State  Board  of  Agriculture,  "together 
with  two  additional  persons  to  be  appointed  by  the  governor," 
to  prepare  a  bill  for  the  inspection  of  market  milk  in  all  its 
stages  from  cow  to  consumer,  to  make  such  amendments  as 
would  eliminate  duplication  of  inspection  or  conflicting  pro- 
visions in  existing  laws,  and  to  thoroughly  cover  the  sanitary 
aspects  of  the  milk  question. 

The  Commission  held  hearings,  traveled  to  other  points  in 
the  United  States,  and  did  more  or  less  inspecting  of  dairies 
and  milk  plants,  as  well  as  examining  the  laboratory  equipment 
for  milk  examination  of  various  cities,  and  conferring  with 
local  health  authorities. 

They  found  existing  duplication  of  laws  and  of  law  enforce- 
ment, but  rather  strangely  make  no  reference  in  their  report  to 
the  large  number  of  cities  and  towns  in  which  no  real  milk 


32 


inspection  or  supervision  of  any  kind  existed  (for  your  Board's 
investigation  reveals  the  fact  that  in  1910  there  was  even  less 
supervision  of  milk  by  local  authorities  than  at  present).  They 
concluded  that  existing  laws  operated  to  the  disadvantage  of 
Massachusetts  producers  as  competitors  with  out-of-State  pro- 
ducers. 

They  recommended  a  State-administered  uniform  system  of 
milk  inspection  enforced  by  a  special  State  Milk  Board,  which 
body  should  have  broad  legislative  and  executive  powers. 

They  point  out  that  both  the  sanitary  and  economic  as- 
pects of  milk  production  demand  reasonable  consideration,  and 
urge  that  no  system  of  State  inspection  of  milk  be  put  into 
effect  unless  funds  are  available  to  adequately  enforce  it. 

A  minority  report  signed  by  the  two  appointed  members 
agrees  in  the  general  scheme  proposed,  but  dissents  from  the 
recommendation  for  a  Special  Milk  Board,  recommending  in 
the  place  of  it  that  "the  milk  act  and  its  regulations  should 
be  administered  by  the  State  Board  of  Health,  in  a  milk  di- 
vision established  for  this  purpose." 

The  direct  result  of  this  investigation  and  report  has  been 
an  annually  recurring  crop  of  proposed  acts  to  settle  the  milk 
questions  of  the  Commonwealth,  none  of  which  have  ever  be- 
come enacted.  (Their  provisions  are  discussed  in  the  following 
section.) 

(c)    The  Boston  Chamber  of  Commerce  Report  of  1915. 

Recently  the  Boston  Chamber  of  Commerce  has  made  an 
extended  report  upon  an  investigation  into  the  milk  situation 
of  New  England.  This  report  naturally  and  properly  confines 
itself  largely  to  the  "business  aspects  of  the  milk  problem." 
It  also  takes  up  the  entire  question  from  a  New  England  rather 
than  from  a  Massachusetts  standpoint. 

The  salient  features  of  this  report  are  that  the  milk  industry 
of  Massachusetts  is  steadily  shriukirg,  but  that  under  certain 
conditions  it  might  be  revived.  This  result  in  the  opinion  of 
this  committee  might  be  brought  about  by  establishing  uniform 
systems  of  grading  and  labeling  throughout  New  England 
(method  by  which  same  is  to  be  accomplished  not  specified); 
by  development  of  co-operative  receiving  stations  by  the  pro- 
ducers;  by  better  bookkeeping  by  farmers;   by  reform  of  trans- 


33 

porta tion  methods;  by  improvements  in  distribution  systems; 
and  by  advertising  more  widely  the  comparative  food  value  of 
cow's  milk. 

Your  Board  has  found  in  many  quarters  of  New  England, 
especially  among  producers,  a  deep-seated  skepticism  as  to  the 
impartiality  and  real  reason  for  this  Boston  Chamber  of  Com- 
merce investigation.  This  has  usually  taken  the  form  of  a 
direct  charge  that  the  entire  investigation  was  undertaken  and 
carried  through  at  the  instigation  of  transportation  interests. 
If  there  be  any  truth  in  this  very  widespread  impression,  a 
careful  study  of  the  report  itself  does  not  reveal  any  definite 
internal  evidence  to  support  it. 

C.    SUMMARY   OF  PROPOSED   LAWS   RELATING   TO   MILK. 

The  following  is  a  list  of  laws  which  have  been  proposed  for 
the  control  of  the  production,  handling  and  sale  of  milk  in  the 
State  of  Massachusetts  during  the  past  five  years. 

i 

Proposed,  1910. 

1.  To  permit  Boston  to  control  its  own  milk  situation. 

2.  Prohibiting  mixing  anything  with  the  whole,  raw  milk. 

3.  Providing  for  milk  board  of  three  from  State  Board  of  Health,  three 

from  Dairy  Bureau,  to  make  regulations  to  be  enforced  by  local 
board  of  health. 

4.  Providing  State  Board  of  Health  to  make  regulations  to  be  enforced 

by  local  board  of  health. 

5.  Providing  Dairy  Bureau  to  draft  bill  which  would  wipe  out  con- 

flicting and  duplicating  inspections. 

6.  Providing  commission  to  investigate  milk  from  cow  to  human  stomach. 

7.  Regulating  railroad  rates  for  transportation. 

8.  Repealing  present  laws  (Acts  of  1906,  chapter  463,  Part  II.,  sections 

202  to  204)  which  attempt  to  regulate  railroad  rates  and  methods. 

Proposed,  1911. 

In  1911  five  bills  were  proposed  for  regulation,  all  mainly 
identical,  but  differing  chiefly  as  to  who  should  make  and  who 
administer  the  regulations. 

1.  State  Board  of  Health  to  make  and  administer  rules  and  regulations. 

(House  1332.) 

2.  Unpaid  board,  three  from  Board  of  Health,  three  from  Board  of  Agri- 

culture; to  make  and  administer.    (House  1476.) 


34 

3.  Paid  board,  two  from  Board  of  Health,  two  from  Board  of  Agri- 

culture, and  one  chosen  by  these,  to  make  regulations.  Adminis- 
tration in  local  boards  of  health.    (House  1943.) 

4.  No  pay  mentioned.     Appointed   by  the   Governor,' — two  medical 

men,  two  practical  producers,  one  sanitarian;  to  make  regulations. 
Administration  in  Milk  Division,  State  Board  of  Health.  (House 
2002.) 

5.  Paid  board,  appointed  by  the  Governor,  five  members,  two  medical 

and  two  producers;  to  make  and  administer  regulations.  (House 
2054.) 

The  following  bills  were  also  proposed :  — 

1.  Requiring  license  for  all  dealers  without  reference  to  amount  sold 

or  to  whom  sold.    (House  361.) 

2.  Authorizing  establishment  of  milk-distributing  stations.    (House  496.) 

3.  Labeling  milk.    (House  1319.) 

4.  Providing  standard  bacteria  count  not  over  500,000.    (House  1130.) 

5.  Any  city  or  town  to  issue  permits.    (House  350.) 

Passed,  but  vetoed,  1911. 

House  2082,  passed  and  vetoed  by  Governor  Foss,  was  identical  with 
House  2002,  except  as  follows :  — 

House  2002  prohibited  selling  without  a  permit  by  dealers  except  "those 
selling  to  others  than  consumers."  This  bill  prohibited  selling  without 
a  permit  by  dealers  except  "those  selling  solely  to  others  than  con- 
sumers."    (Section  4.) 

House  2002  stated:  "  This  bill  not  to  be  construed  to  make  legal  what 
is  now  prohibited  nor  to  affect  present  local  regulations."    (Section  20.) 

House  2082  added,  "provided  said  municipal  regulations  do  not  conflict 
with  this  act  nor  with  regulations  which  may  be  made  under  it." 

Proposed,  1812. 

1.  No  pay  mentioned.     Five  members   appointed  by  Governor  with 

advice  of  Council, — two  medical,  two  producers,  1  sanitarian; 
to  make  regulations.  Administration,  State  Board  of  Health. 
(House  1570,  Ellis.) 

2.  Paid  board,  six  members;    three  from  State  Board  of  Health,  three 

from  State  Board  of  Agriculture;  to  make  regulations.  Administra- 
tion by  local  boards  of  health.    (House  1571,  Meaney.) 

3.  Giving  full  power  to  State  Board  of  Health  to  make  and  administer 

regulations  on  milk  question.    (House  1049,  Withington.) 

4.  State  Board  of  Health  to  make  regulations  subject  to  approval  by 

Governor  and  Council,  and  requiring  publishing  in  advance  of 
approval.    (House  1568,  Fowler.) 


35 


Proposed,  1913. 

1.  Authorizing  local  board  of  health  to  issue  permits  or  forbid  sale. 

(House  612,  City  of  Boston.) 

2.  Stating  many  prohibitory  conditions,   including  maximum  bacteria 

count  of  200,000  to  be  administered  by  State  Board  of  Health. 
(House  1569,  Putnam.) 

3.  Almost  identical  with  House  1568,  1912,  except  instead  of  State  Board 

of  Health  making  and  administering  rules  and  regulations,  a  special 
milk  board  of  five  members,  appointed  by  the  Governor  and  Council, 
—  two  medical,  two  producers,  one  sanitarian, — is  provided;  regu- 
lations to  be  published  and  then  approved  by  Governor  and  Council, 
then  to  be  administered  by  State  Board  of  Health.  (House  393, 
Bradley.) 

Proposed,  1914. 

1.  Relative  to  inspection  of  dairies  and  cows  and  of  barns  and  other 

enclosures  where  cows  are  kept  for  the  production  of  milk.  Except 
in  case  of  contagious  disease  now  under  jurisdiction  of  State  Board 
of  Health,  no  other  inspection  shall  be  made  than  that  by  the  Com- 
missioner of  Animal  Industry,  such  inspection  to  be  made  under 
such  regulations  as  agreed  upon  by  State  Board  of  Health  and  said 
Commissioner.     (Senate  234,  Moore.) 

2.  Relative  to  inspection  by  boards  of  health  of  milk  and  other  articles 

of  food  with  right  to  seize  unwholesome  or  unfit  milk  or  food. 
(House  877.) 

3.  Relative  to  licensing  of  persons,  partnerships,  corporations,  except 

the  producer  selling  to  others  than  consumers  or  not  to  exceed  five 
quarts  per  day  to  consumers,  in  cities  or  towns  where  a  milk  in- 
spector is  appointed.     (House  588,  McGrath.) 

4.  Providing  for  State  milk  regulation  board  to  make  regulations  for 

production,  transportation,  keeping  and  sale  of  milk;  five  members 
appointed  by  Governor  with  advice  and  consent  of  Council,  two 
learned  in  the  science  of  medicine  or  bacteriology,  two  practical 
producers  and  one  sanitarian.  Rules  and  regulations  to  be  approved 
by  Governor  and  Council  and  administered  by  State  Board  of 
Health  or  other  municipal  boards  of  health.  Appropriation  $50,000. 
(House  775,  Bigelow.) 

5.  Safeguard  the  public  health  from  dangers  of  milk  injurious  to  public 

health.  Boards  of  health  of  any  city  or  town  authorized  to  exclude 
milk  or  cream  deemed  to  be  injurious  to  health.  Prohibiting  the 
bringing  into  the  State  for  sale  in  any  city  or  town  such  milk  or 
cream  as  may  have  been  condemned.  Penalty  $25  to  $100.  (House 
780.) 

6.  Terms  "milk"  and  "pure  milk"  to  be  defined.    The  terms  "milk" 

and  "pure  milk"  as  used  in  section  55  of  chapter  56  of  the  Revised 
Laws  to  apply  to  cream,  buttermilk  or  any  fluid  or  semi-fluid  product 


36 

of  milk  except  evaporated,  concentrated  or  condensed  milk  when 
not  diluted  with  water,  which  is  to  be  employed  as  milk,  cream  or 
buttermilk.  In  the  manufacture  of  evaporated,  concentrated  or 
condensed  milk  the  use  of  cane  sugar  is  permitted.    (House  781.) 

7.  For  further  regulations  of  prosecutions  in  milk  cases.    A  dealer  of 

milk  not  to  be  liable  to  prosecution  unless  the  sample  of  milk  which 
it  is  charged  he  has  sold,  exchanged,  delivered  or  had  in  his  posses- 
sion with  intent  to  sell,  exchange  or  deliver  was  taken  upon  his 
premises  or  while  in  his  possession  by  the  inspector  of  milk  or  by  the 
agent  of  the  Dairy  Bureau  or  of  the  State  Board  of  Health,  and  a 
sealed  portion  thereof  was  given  him  at  the  time  of  taking.    (House 

934,  Connor.) 

8.  Regulation  of  sending  of  results  of  analysis  of  milk  by  inspectors. 

Amending  section  63  of  chapter  56  of  the  Revised  Laws  so  that  such 
inspectors  shall  send  to  persons  responsible  for  the  condition  of 
sample  of  milk  the  results  of  the  analysis  within  three  daj^s.    (House 

935,  Connor.) 

9.  Massachusetts  Milk  Consumers'  Association  for  protecting  the  public 

health  and  the  promotion  of  the  milk  industry  of  the  Common- 
wealth. State  regulation,  milk  board;  five  men  appointed  by  the 
Governor  with  the  advice  and  consent  of  the  Council,  two  learned 
in  medicine  or  bacteriology,  two  men  of  practical  experience  in  the 
production  of  milk  and  one  sanitarian.  Regulations  to  be  approved 
by  Governor  and  Council  and  administered  by  State  Board  of 
Health  and  municipal  boards  of  health  under  supervision  of  State 
Board  of  Health.  Permits  from  State  Board  of  Health  to  sell  milk. 
Creation  of  milk  division  of  State  Board  of  Health,  with  chief  of 
division  and  milk  inspectors  not  to  exceed  twenty  in  number 
and  such  other  employees  as  necessary.  Appropriation  $50,000. 
(House  936.) 

10.  To  prohibit  the  sale  of  milk  and  milk  products  produced  under  in- 

sanitary conditions.  Fine  of  not  more  than  $300  or  imprisonment 
for  sixty  days,  or  by  both.  Supreme  Court  to  have  jurisdiction  in 
equity  upon  appeal  of  State  Board  of  Health  or  anj1-  local  board  of 
health  to  enjoin  sale  of  such  milk  or  milk  products.  (House  937, 
Sullivan.) 

11.  To  exclude  out-of-State  milk  not  produced  or  handled  under  sanitary 

conditions.  The  State  Board  of  Health  is  authorized  to  spend  for 
salaries  and  expenses  for  necessary  inspection  of  dairies,  creameries, 
stores  and  contractors'  plants,  railroad  cars  used  for  the  transpor- 
tation of  milk,  and  other  conveyances  and  places  outside  the  State 
in  which  milk,  cream  or  their  products  are  stored  when  they  are 
intended  for  sale  within  this  State.  Appropriation  $35,000.  Penalty 
$300  or  ninety  days'  imprisonment,  or  both. 
Milk  to  be  labeled  or  marked  by  name  of  State  in  which  it  was  produced, 
and  also  what  artificial  treatment,  if  any,  has  been  employed,  as 


37 

"Massachusetts  Milk,"  "Maine  Milk,"  "New  York  Milk,"  etc.; 
"pasteurized,"  "natural,"  "modified"  or  "compound  milk."  Milk 
pasteurized  two  or  more  times  shall  be  so  marked.  Penalty  clause 
not  filled  in.    (House  1409,  John  J.  Lydon.) 

12.  Amendment  to  law  relative  to  inspection  and  sale  of  milk.    Sample 

of  equal  size,  sealed  and  delivered  to  the  person  having  milk  sampled 
at  the  same  time  when  sample  is  taken  for  analysis.  Results  of 
analysis  to  be  sent  to  party  within  five  days.  Twenty-day  clause 
for  producers.  Cities  of  50,000  population  or  over  shall  cause  all 
milk  or  cream  sold  therein  to  be  pasteurized  at  145  degrees  F.  for 
thirty  minutes.  All  milk  inspectors,  as  provided  by  law,  shall  pub- 
lish monthly  records  of  analyses  and  names  of  persons  from  whom 
samples  were  taken.    (House  1408,  Murray.) 

13.  Producers  of  milk  shall  be  reimbursed  for  damages  suffered  from 

non-sale  of  milk  during  epidemics  as  a  result  of  orders  of  boards  of 
health.     (House  1520,  Kimball.) 

14.  Every  city  and  every  town  of  over  6,000  population  shall  establish 

public  milk  stations  in  charge  of  milk  inspectors  or  other  persons 
designated  by  local  boards  of  health.  Distribution  shall  be  made 
for  the  sole  purpose  of  benefiting  persons  whose  personal  or  family 
conditions  make  it  imperative  that  they  be  entitled  to  the  benefit 
thereof,  the  price  of  the  milk  to  be  subject  to  the  control  of  the 
local  board  of  health,  with  the  right  of  appeal  to  city  council  or 
board  of  selectmen.  Milk  to  be  inspected  once  a  week  at  least  to 
avoid  danger.  Business  shall  be  conducted  so  that  no  financial  loss 
to  distributors  shall  take  place  or  to  establish  no  offensive  competi- 
tion with  local  dealers.    (House  2104,  Arkwell.) 

15.  To  authorize  cities  and  towns  to  compensate  certain  owners  of  milk 

at  prevailing  wholesale  rates  when  owners  are  prevented  from  selling 
by  orders  of  boards  of  health  because  of  presence  of  contagious  or 
communicable  disease.  No  compensation  if  existence  of  disease  is 
due  to  negligence  or  fault  of  owner.    (House  2158,  Putnam.) 

16.  Relative  to  inspection  by  boards  of  health  of  milk  and  other  articles 

of  food.  Right  to  seize  unwholesome  or  unfit  milk  or  food.  (House 
2156.) 

D.    SUMMARY  OF  PRESENT  MILK  LAWS. 

Boards  of  health  of  cities  shall,  and  boards  of  health  of  towns 
may,  appoint  milk  inspectors,  compensation  determined  by  the 
appointing  boards.  (Acts  of  1909,  chapter  405,  amended  by 
Acts  of  1910,  chapter  114.) 

No  person  in  the  milk  business  shall  be  appointed  an  in- 
spector of  milk.     (Acts  of  1910,  chapter  457.) 

Each  inspector  shall  be  sworn  and  shall  publish  his  appoint- 


38 

ment  for  two  weeks  in  a  newspaper.  (Revised  Laws,  chapter 
56,  section  51.) 

Inspectors  shall  keep  an  office,  and  record  in  books  the  name 
and  place  of  business  of  all  persons  engaged  in  the  sale  of  milk. 
The  board  of  health  may  employ  collectors  who  shall  be  sworn. 
The  inspectors  or  collectors  may  enter  premises  and  take  sam- 
ples of  milk.  They  shall  upon  request  make  sealed  samples, 
a  receipt  for  which  must  be  given  to  the  inspector.  The  in- 
spectors shall  cause  such  samples  to  be  examined,  and  shall 
keep  a  record  of  the  analyses.  If  sealed  sample  is  refused  no 
evidence  of  the  analysis  can  be  introduced.  (Revised  Laws, 
chapter  56,  section  52,  amended  by  Acts  of  1909,  chapter  405.) 

The  State  Department  of  Health  may  appoint  inspectors, 
analysts  and  chemists.  Inspectors  have  the  same  authority  to 
collect  samples  as  is  given  to  inspectors  and  collectors  of  milk. 
(Revised  Laws,  chapter  75,  section  5,  amended  by  Acts  of  1910, 
chapter  394.) 

The  State  Department  of  Health  has  appropriation  of  $17,500, 
three-fifths  of  which  must  be  spent  for  the  enforcement  of  milk 
laws.  (Revised  Laws,  chapter  75,  section  6,  amended  by  Acts 
of  1903,  chapter  467;    1907,  chapter  208;    1911,  chapter  296.) 

The  Board  of  Agriculture  at  its  annual  meeting  appoints  a 
general  agent  of  the  Dairy  Bureau.  The  Dairy  Bureau  con- 
sists of  three  members,  one  of  whom  is  appointed  annually  by 
the  Governor  for  a  term  of  three  years.  The  secretary  of  the 
Board  of  Agriculture  is  the  executive  officer  of  the  Bureau. 
The  Bureau  inquires  into  the  methods  of  butter  and  cheese 
making,  and  enforces  the  laws  relative  to  the  sale  of  all  dairy 
products  and  their  imitations.  The  Bureau  has  an  appropria- 
tion of  $8,000  per  annum.  It  may  co-operate,  but  must  not 
interfere  with  the  State  Department  of  Health  and  with  in- 
spectors of  milk.  The  agents  of  the  Bureau  have  the  same 
authority  as  is  given  to  inspectors  and  collectors  of  milk.  Pen- 
alty for  obstruction,  first  offence,  $100;  subsequent  offences, 
$200,  with  fine  payable  to  the  Treasurer  of  the  Commonwealth. 
(Revised  Laws,  chapter  89,  sections  5,  11,  12  and  13,  amended 
by  Acts  of  1891,  chapter  412;  J892,  chapter  139;  1894,  chapter 
280;  1895,  chapter  214;  1900,  chapter  368;  1905,  chapter  155; 
1907,  chapter  401;    and  1908,  chapter  416.) 


39 

Unlawful  to  sell  milk  without  a  permit.  Permits  are  issued 
by  local  boards  of  health  after  a  satisfactory  inspection  of  the 
milk  and  of  the  dairies  and  of  the  premises  upon  which  the 
milk  has  been  handled.  No  charge  for  inspection.  These  in- 
spections must  be  made  by  the  authorized  agents  of  the  board. 
The  boards  may  require  such  reasonable  conditions  as  they  see 
fit.  If  a  permit  is  revoked  the  board  of  health  must  notify  the 
State  Department  of  Health.  The  latter  must  notify  other 
boards  of  health  in  whose  jurisdiction  the  milk  is  liable  to  be 
soid,  and  must  notify  dealers  liable  to  purchase  the  milk.  Un- 
lawful to  sell  after  receiving  such  notice.  Permits  may  be 
reissued  by  local  boards  of  health.  Penalty  not  more  than 
$100.  (Acts  of  1914,  chapter  744,  amended  by  Acts  of  1916, 
chapter  228.) 

Unlawful  for  any  State  or  municipal  inspector  to  charge  for 
the  inspection  of  live  stock,  dairy,  etc.  (General  Acts  of  1915, 
chapter  109.) 

No  person  shall  sell  milk  without  a  license.  Exception:  a 
producer  selling  to  dealers  or  not  more  than  20  quarts  to  con- 
sumers. The  license  shall  be  numbered  and  shall  contain  the 
name,  place  of  business,  residence,  number  of  wagons  and 
names  of  drivers,  and  shall  be  conclusive  evidence  of  owner- 
ship. Name,  place  of  business  and  license  numbers  must  be 
painted  on  wagons,  and  license  must  be  posted  in  stores.  Pen- 
alty for  operating  without  a  license,  first  offence,  $10  to  $100; 
second  offence,  $50  to  $300;  third  offence,  $50  and  imprison- 
ment for  thirty  to  sixty  days.  Fee  for  license,  50  cents.  Li- 
cense remains  in  force  until  the  first  day  of  June.  May  be 
revoked  for  violation  of  the  terms  of  the  license.  If  license  is 
revoked  licensee  has  an  appeal  to  the  State  Department  of 
Health,  whose  decision  shall  be  final  and  conclusive.  (Acts  of 
1909,  chapter  443.) 

Utensils  used  in  determining  fat  by  the  Babcock  or  other 
centrifugal  methods  must  be  approved  or  calibrated  by  the 
Massachusetts  Agricultural  Experiment  Station.  Persons  oper- 
ating these  machines  must  have  a  certificate  from  the  experi- 
ment station.  Exception:  persons  doing  such  work  for  their  own 
information,  not  for  inspection  or  as  a  basis  for  payment  in  buy- 
ing or  selling.    Penalty,  $15  to  $50.    (Acts  of  1912,  chapter  218.) 


40     '. 

Milk  which  has  been  heated  to  a  temperature  greater  than 
167°  F.  must  be  labeled  "Heated  Milk."  Penalty,  first  offence, 
$50  to  $200;  second  offence,  $100  to  $300;  subsequent  offences, 
$50  and  imprisonment  for  sixty  to  ninety  days.  (Acts  of  1908, 
chapter  570.) 

Sale,  etc.,  prohibited  of  adulterated  milk,  or  milk  to  which 
water  or  any  foreign  substance  has  been  added,  or  milk  from 
cows  fed  on  the  refuse  of  distilleries,  or  from  sick  cows,  or  as 
pure  milk,  milk  from  which  a  part  of  the  cream  has  been  re- 
moved, or  skimmed  milk  containing  less  than  9.3  per  cent, 
solids  not  fat.  Penalty,  first  offence,  $50  to  $200;  second 
offence,  $100  to  $300;  subsequent  offence,  $50  and  imprison- 
ment for  sixty  to  ninety  days.  (Revised  Laws,  chapter  56, 
section  55.) 

Sale,  etc.,  prohibited  of  milk  below  the  legal  standard.  Pen- 
alty, first  offence,  not  more  than  $50;  second  offence,  $100  to 
$200;  subsequent  offences,  not  more  than  $200  or  not  more  than 
ninety  days.  (Revised  Laws,  chapters  56  and  57,  amended  by 
Acts  of  1910,  chapter  641.) 

Producer  not  liable  for  sale  of  low  standard  milk  unless  low 
in  both  solids  and  fat,  and  unless  twenty  days  after  he  has 
received  notice  of  this  fact  a  second  sample  is  found  by  the 
same  inspector  to  be  low  in  solids  and  fat.  Furthermore,  sam- 
ples must  be  taken  while  in  his  possession  or  in  his  control  by 
an  inspector,  and  a  sealed  sample  given.  (Revised  Laws,  chap- 
ter 56,  section  62,  amended  by  Acts  of  1910,  chapter  641.) 

Standard:  solids,  12.15  per  cent.;  fat,  3.35  per  cent.  (Re- 
vised Laws,  chapter  56,  section  56,  amended  by  Acts  of  1908, 
chapter  641.) 

Skimmed  milk  may  be  sold  if  labeled  with  the  words 
"Skimmed  Milk"  in  letters  1  inch  in  length.  (Revised  Laws, 
chapter  56,  section  58.) 

Use,  etc.,  of  counterfeit  seal,  or  tampering  with  sample, 
punished  by  fine  of  $100  or  imprisonment  three  to  six  months. 
(Revised  Laws,  chapter  56,  section  60.) 

Obstruction  of  inspector  punished  by  fine  of  $100  to  $300  or 
imprisonment  thirty  to  sixty  days.  (Revised  Laws,  chapter  56, 
section  61.) 

The  inspectors  must  make  complaint  upon  receipt  of  evi- 
dence.    (Revised  Laws,  chapters  56  and  64.) 


41 

Analyses  of  samples  must  be  sent  to  the  person  from  whom 
sample  was  taken.     (Revised  Laws,  chapters  56  and  63.) 

Use  of  unclean  containers  and  implements  punished  by  fine 
of  not  more  than  $50.     (Acts  of  1913,  chapter  761.) 

Placing  substances  other  than  milk  and  milk  products  and 
cleaning  fluids  in  milk  cans  or  bottles  punished  by  not  more 
than  $10  for  each  vessel  misused.  Returning  dirty  cans  to 
producers  punished  by  fine  of  not  more  than  $10  for  each  such 
vessel.     (Acts  of  1906,  chapter  116.) 

Milk  dealers  must  not  use  cans  not  their  own.  Penalty,  $10. 
(Acts  of  1906,  chapter  116,  amended  by  Acts  of  1908,  chapter 
435.) 

Commissioner  of  Animal  Industry  may  inspect  premises 
where  cattle,  etc.,  are  kept.  He  may  make  and  enforce  regula- 
tions for  the  sanitary  condition  of  the  premises  subject  to  ap- 
proval by  the  Governor  and  Council.  State  Department  of 
Health,  Dairy  Bureau  and  boards  of  health  must  report  all 
premises  found  to  be  unsanitary.  Penalty  for  obstruction,  not 
more  than  $50  or  imprisonment  not  more  than  thirty  days. 
(Acts  of  1911,  chapter  381.) 

Feeding  garbage  collected  by  a  city  or  town  to  milch  cows 
prohibited.  Penalty  not  more  than  sixty  days  or  not  more 
than  $100.  Feeding  garbage  collected  from  a  city  of  more  than 
30,000  inhabitants  to  any  animal  except  swine  prohibited.  Pen- 
alty, not  more  than  thirty  days  or  fine  not  more  than  $50. 
(Revised  Laws,  chapter  213,  section  5.) 

Medical  milk  commissions  may  be  formed.  The  members 
of  the  board  of  health  may  be  ex  officiis  members.  Members 
shall  receive  no  compensation.  The  corporation  may  make 
agreements  for  the  production  of  milk  under  their  supervision, 
but  the  conditions  shall  not  fall  below  those  imposed  for  cer- 
tified milk  by  the  American  Association  of  Medical  Milk  Com- 
missions, or  below  the  statutory  standard.  Penalty  for  sale  of 
milk  not  conforming  to  the  regulations,  not  more  than  $100. 
(Acts  of  1911,  chapter  506.) 

Boards  of  health  of  cities  and  of  towns  having  10,000  or  more 
inhabitants  may  establish  stations  for  the  distribution  of  milk 
free  of  charge  or  at  such  charge  as  the  board  may  establish. 
The  boards,  however,  must  not  engage  in  the  general  milk 
business.     (Acts  of  1911,  chapter  278.) 


42 


PART  II.     STATEMENTS   OF  VARIOUS  INTERESTS. 


INTRODUCTION. 

It  was  the  desire  of  your  Board  to  obtain  as  many  view- 
points from  as  many  different  interests  concerned  in  the  pro- 
duction and  the  sale  of  milk  as  possible,  and  therefore  a  num- 
ber of  letters  were  sent  to  different  organizations. 

A  questionnaire  of  nine  questions  was  sent  to  certain  of  the 
large  milk  contractors;  six  questions  requested  definite  informa- 
tion upon  certain  phases  of  the  operation  of  their  business,  and 
three  were  relative  to  their  opinion  of  the  present  milk 
situation.  Letters  were  sent  to  cattle  breeders'  associations 
asking  whether  or  not  they  would  approve  of  selling  milk  upon 
its  fat  percentage.  A  letter  was  sent  to  the  State  Department 
of  Animal  Industry  relative  to  the  inspection  of  cattle,  and 
that  Department  was  asked  to  give  an  opinion  upon  the  health 
of  Massachusetts  cattle  at  present  as  compared  with  that  in 
former  years. 

The  Boston  Chamber  of  Commerce,  the  State  Grange,  the 
Milk  Consumers  League,  the  Milk  and  Baby  Hygiene  Associa- 
tions, the  Massachusetts  State  Board  of  Agriculture  and  the 
Health  Department  of  the  city  of  Boston  were  all  requested  to 
submit  statements  giving  the  viewpoints  of  their  respective  or- 
ganizations relative  to  the  milk  situation  in  Massachusetts. 

The  answers,  wherever  possible,  have  been  reported  in  full, 
but  in  a  few  instances  it  has  been  necessary  to  make  com- 
pilations. 

A.    MILK  CONTRACTORS. 

A  questionnaire  was  sent  to  milk  contractors,  a  portion  of 
which  dealt  with  their  opinions  relative  to  the  milk  situation.1 
From  the  answers  received  the  following  has  been  compiled :  — 

Question  7.  —  Do  you  consider  that  the  present  competitive  system 
of  retail  milk  delivery  involves  an  unnecessary  duplication  of  equip- 
ment and  labor? 

1  The  balance  of  the  answers  are  discussed  in  Part  III.,  Section  B. 


43 

To  this  question  7  answered  no,  3  yes,  and  1  gave  no  answer, 
stating  that  he  made  no  retail  sales.  One  complete  answer  is 
as  follows:  — 

7.  In  large  centers  of  population  where  the  business  is  of  considerable 
volume  that  is  carried  on  and  operated  by  a  dealer,  we  think  that  there 
is  little  chance  to  improve  upon  the  city  milk  delivery.  A  number  of 
years  ago,  when  the  distribution  of  milk  was  in  the  hands  of  milkmen 
who  ran  one  or  two  teams,  there  was  of  necessity  long  drives  and  scattered 
deliveries.  One  can  readily  see  the  way  the  business  is  now  carried  on 
by  large  dealers,  —  a  customer  moving  from  one  section  of  the  city  to 
another  is  simply  transferred  to  the  team  delivering  in  that  section; 
but  under  conditions  that  existed  as  referred  to  above,  the  small  milk- 
men who  operated  one  or  two  teams  would  either  have  to  give  up  the 
customer  who  moved  to  another  part  of  the  city,  or  lengthen  out  his 
drive,  which,  of  course,  is  a  costly  thing  to  do.  We  try  to  load  up  our 
wagons  and  divide  the  territory  so  that  we  give  one  man  a  full  day's 
work,  and  also  try  to  arrange  the  deliveries  so  that  one  horse  is  all  that 
is  necessary  usually  to  run  the  team. 

Question  8.  —  Is  there  a  surplus  or  a  shortage  of  milk  at  different 
seasons  of  the  year  in  your  milk  producing  territory,  and  if  so,  please 
state  your  opinion  of  the  reason  therefor. 

All  eleven  answered  yes  to  this  question.  The  variation 
in  the  amount  of  milk  upon  the  market  was  explained  by 
natural  causes,  unavoidable  causes  and  faults  of  production. 
The  cows  are  generally  allowed  to  freshen  in  the  springtime, 
and  the  farmers  do  not  attempt,  as  a  rule,  to  control  the  flow 
of  milk  by  regulating  the  time  of  breeding. 

On  the  other  hand,  the  demand  for  milk  varies  with  the  tem- 
perature. During  the  extremely  hot  days  there  is  an  enormous 
demand  for  milk  without  a  corresponding  increase  in  produc- 
tion. The  present  shortage  in  the  hot  weather  is  not  so  severe 
as  formerly,  owing  to  the  fact  that  many  farmers  are  beginning 
to  arrange  their  herds  so  that  more  milk  will  be  produced  dur- 
ing the  hot  weather. 

One  complete  reply  is  as  follows :  — 

8.  Generally  speaking,  there  is  marked  irregularity  in  the  production 
of  milk,  the  largest  quantity  occurring  in  the  months  of  May  and  June, 
and  the  smallest  in  the  months  of  October  and  November.  Both  the 
excess  production  and  the  under  production  from  the  average  level  result 


44 

in  heavy  cost  to  the  industry.  In  the  case  of  surplus  no  use  is  available 
which  will  yield  the  full  cost  of  the  milk,  and  in  the  case  of  shortage  the 
supply  has  to  be  replenished  from  new  sources  of  exorbitant  prices. 

Notwithstanding  instruction  to  producers  as  to  the  need  of  the  market 
for  even  production,  and  notwithstanding  the  application  of  a  heavy 
grade  in  prices,  the  producer,  in  general,  persists  in  uneven  production. 
This  is  due,  presumably,  to  the  tradition  of  producing  maximum  amounts' 
on  summer  pasturage,  and  again,  to  the  consideration  that  milk  on  most 
farms  is  not  the  sole  product,  and  the  production  of  milk  is  not  inten- 
sively carried  on. 

Question  9.  —  Do  you  consider  the  present  milk  situation  in  Massa- 
chusetts satisfactory  from  the  dealer's  point  of  view?  If  not,  would 
you  kindly  state  in  your  opinion  what  changes  could  or  should  be  made 
to  place  the  business  on  a  more  satisfactory  basis? 

To  this  question  seven  answered  no,  two  answered  yes  and 
two  gave  no  answer.     The  following  suggestions  were  made :  — 

Increase  the  license  fee  to  $50,  which  will  prevent  incom- 
petent men  from  going  into  the  milk  business,  and,  further- 
more, prohibit  by  statute  any  person  engaging  in  the  business 
without  adequate  equipment., 

Milk  from  uninspected  sources  and  of  doubtful  origin  is  now 
allowed  to  compete  with  Massachusetts  producers.  To  offset 
this,  uniform  regulations  should  be  made,  placing  the  enforce- 
ment of  dairy  inspection  in  the  control  of  the  State  Depart- 
ment of  Health. 

Another  contractor  stated  that  multiple  inspection  under  the 
provisions  of  chapter  744  of  the  Acts  of  1914  should  be  stopped 
in  favor  of  State  Department  of  Health  inspection.  Another  con- 
tractor suggested  lessening  the  legislative  activity,  and  placing 
the  inspection  of  dairies  under  the  control  of  the  State  Depart- 
ment of  Health.  One  contractor  suggested  compulsory  pas- 
teurization of  milk  in  large  cities  under  the  supervision  of  the 
State  Department  of  Health. 

Price  cutting  is  stated  to  be  ruinous  among  dealers,  as  is  also 
the  practice  of  selling  bottled  milk  in  stores  at  cost.  The  selling 
of  milk  on  its  quality  by  different  grades  would  give  the  con- 
sumer a  reliable  basis  for  a  differentiation  of  quility,  and  would 
standardize  competition  among  dealers.  Another  contractor 
with  this  same  idea  suggested  statutes  permitting  the  sale  of 
standardized  milk  and  the  sale  of  milk  on  the  fat  basis. 


45 

The  present  conditions  do  not  encourage  milk  production  in 
Massachusetts.     Long-distance  milk  is  cheaper  and  discourages 
home  production.     The  Saunders  law  did  not  handicap  dealers 
in  getting  milk,  but  probably  has  been  of  no  benefit  to  Massa-- 
chusetts  producers. 

Another  contractor  suggested  amending  the  laws  so  that 
dealers  may  be  seen  on  the  street  corners  together  without 
danger  of  arrest.     One  complete  reply  is  as  follows:  — 

9.  Under  the  law  of  1914  cities  and  towns  of  the  State  are  required 
to  inspect  and  to  license  dairies  supplying  them  with  milk.  This  results 
in  a  multiplication  of  permits,  to  the  extent  that  producers  supplying 
dealers  covering  greater  Boston  may  have  permits  from  twenty  boards 
of  health.  We  believe  the  interests  of  all  concerned  in  milk,  viz.,  the 
producer,  distributor,  board  of  health  and  consumer,  would  be  more 
agreeably,  effectively  and  economically  served  by  centralizing  the  in- 
spection of  dairies  under  the  authority  of  the  State. 

We  believe  that  the  pasteurization  of  milk  in  the  large  cities  of  the 
State  should  be  made  compulsory,  and  that  the  process  should  be  carried 
on  under  conditions  prescribed  by  the  State  Department  of  Health. 

We  believe  that  the  sanitary  problem  in  milk  has  resolved  itself  chiefly 
into  an  economic  problem.  Knowledge  as  to  the  sanitary  measures 
required  for  producing  and  handling  clean  and  safe  milk  is  widely  dis- 
seminated. What  lacks  is  the  application  of  this  knowledge,  which  is 
"a  business  matter.  The  establishment  of  the  sale  of  milk  on  a  basis  of 
quality  through  the  definition  of  grades  would  afford  the  consumer  a 
reliable  basis  for  the  differentiation  of  quality,  would  standardize  compe- 
tition among  dealers,  and  would  permit  compensation  of  producers  on 
a  basis  of  quality.  The  consumer  could  then  have  the  grade  of  milk 
desired  by  paying  the  appropriate  price.  We  accordingly  urge  the  es- 
tablishment of  grades  for  sale  of  milk  in  the  large  cities  of  the  State. 

We  urge  the  enactment  of  law  prescribing  the  sale  of  cream  on  a  basis 
of  fat. 

The  present  requirement  of  law  of  9.3  per  cent,  solids  not  fat  in  skimmed 
milk  is  higher  than  genuine  milk  will  show.  We  therefore  urge  a  change 
to  8.75  per  cent. 

We  recommend  that  the  boards  of  health  of  the  towns  and  cities  in 
greater  Boston  standardize  their  regulations  controlling  the  delivery  of 
milk  to  homes  in  which  an  infectious  disease  exists.  There  is  now  con- 
siderable difference  in  the  requirements  of  different  localities.  Generally 
speaking,  the  milk  dealer  is  held  responsible  to  the  board  of  health  for 
seeing  that  this  is  done.  We  believe  that  the  householder  should  be 
made  completely  responsible,  by  such  means  as  retaining  bottles  in  the 
household  until  the  disease  is  over  and  until  bottles  have  been  disinfected 
by  the  board  of  health  or  under  its  direction.    Such  a  requirement  would 


46 

be  seen  to  cover  the  case  of  bottles  bought  through  the  stores  for  use  in 
infectious  households  where  now,  according  to  our  understanding,  they 
escape  supervision.  The  sale  of  milk  in  bottles  through  the  stores  now 
constitutes  a  large  part  of  the  city  supply. 

B.    BOSTON  CHAMBER  OF  COMMERCE. 

Dec.  20,  1915. 
Mr.  Edward  H.  Williams,  Room  141,  State  House,  Boston,  Mass. 

Dear  Mr.  Williams:  —  I  have  your  letter  of  December  18,  in  which 
you  state  that  you  would  like  to  have  a  statement  from  ■  us  in  regard  to 
the  milk  situation. 

You  already  have  copies  of  our  milk  report,  which  gives  a  summary 
of  the  present  conditions  and  our  opinion  as  to  what  is  necessary  to 
remedy  some  of  the  present  difficulties.  I  am  enclosing  a  leaflet  which 
will  give  you  an  idea  of  our  future  plans.  We  are  just  sending  the  third 
edition  of  this  report  to  the  press.  The  fourth  edition  will  come  out 
some  time  in  February.  It  seems  to  us  that  the  first  thing  to  do  is  to 
get  a  wide  distribution  of  the  report,  co-operating  with  the  various 
agencies  interested,  in  order  that  a  large  number  of  people  interested  in 
the  dairy  industry  may  become  acquainted  with  present  conditions  and 
the  suggested  remedies. 

Up  to  date,  almost  every  agency  has  been  looking  at  the  suggestion 
from  their  own  point  of  view,  forgetting  the  bearing  that  the  other  con- 
ditions bad  upon  their  particular  problem.  Again,  many  people,  in 
order  to  accomplish  certain  needed  reforms,  are  so  anxious  to  overturn . 
in  a  few  months  conditions  that  have  been  growing  for  a  period  of  many 
years  that  they  generally  do  not  succeed.  After  securing  a  wide  distribu- 
tion of  the  report,  we  hope  that  a  plan  can  be  laid  out  by  a  conference 
of  the  agencies  interested,  whereby  the  recommendations  as  to  the  par- 
ticular phases  of  the  production,  transportation,  inspection  and  distri- 
bution of  milk  and  cream  can  be  carried  out  step  by  step. 

For  instance,  take  the  grading  and  labeling  of  milk.  A  pamphlet 
should  be  issued  telling  how  grading  and  labeling  can  be  really  carried 
out;  what  is  necessary  to  be  done  in  order  to  interest  the  people,  such 
as  holding  meetings  of  health  officials,  town  and  city  authorities,  dealers, 
producers,  consumers,  etc.;  the  equipment  necessary  for  a  laboratory, 
the  cost  of  operation  and  cost  per  sample,  and  the  cost  per  capita.  Tins 
should  be  figured  out  according  to  the  population  of  the  various  munici- 
palities, showing  what  it  would  cost  cities  of,  say,  500,000  and  over; 
100,000  to  500,000;  50,000  to  100,000;  5,000  to  50,000;  and  under 
5,000.  These,  of  course,  are  only  fictitious  divisions,  and  it  may  be 
found  upon  further  study  that  they  would  have  to  be  in  different  divisions. 
Tins  would  give  in  detail  how  the  grading  and  labeling  of  milk  should 
be  carried  out,  and  this  is  what  the  people  need. 

The  same  thing  should  be  done  in  regard  to  every  recommendation 


47 

as  to  country  milk  plants,  railroad  transportation,  better  methods  of 
production,  distribution,  etc.,  outlining  a  detailed  plan  of  just  what  can 
be  done,  providing  the  people  wish  to  take  some  initiative. 

Undoubtedly  some  legislation  will  have  to  be  secured  in  regard  to 
making  the  local  standards  more  or  less  uniform  as  to  milk  and  cream 
and  ice  cream;  the  problem  of  the  country  dairy  inspection;  and  the 
granting  of  authority  to  boards  of  health  to  issue  licenses  for  the  grading 
and  labeling  of  milk.  Undoubtedly  your  Board  has  looked  into  these 
matters  and  is  more  or  less  familiar  with  the  situation. 

I  am  sure  that  I  personally,  and  other  members  of  our  committee 
would  be  very  glad  to  have  a  conference  with  your  committee  any  time 
to  discuss  these  three  particular  questions,  or  others  pertaining  to  this 
oft-vexed  and  much-perplexed  problem. 

Very  truly  yours, 

John  C.  Orctjtt, 
Secretary,  Committee  on  Agriculture. 

C.    MILK  CONSUMERS'  LEAGUE. 

The  Massachusetts  Milk  Consumers'  Association  dates  its  organization 
from  1910.  It  consists  of  over  1,800  prominent  men  and  about  10  women, 
very  evenly  distributed  throughout  the  various  representative  districts 
of  the  State.  Its  purpose  is:  "An  association  formed  to  unite  consumers 
in  obtaining  efficient  inspection  and  a  pure  milk  supply." 

The  organization  was  evolved  from  three  sources,  namely,  Dr.  Charles 
Harrington,  former  secretary  of  the  State  Board  of  Health,  the  official 
legislative  investigating  committees  of  1910  and  1911,  and  the  health 
committee  of  the  Municipal  League. 

For  several  years  prior  to  1911  Dr.  Harrington  introduced  bills  in  the 
Legislature  designed  to  enable  the  State  Board  of  Health  to  enforce  its 
suggestions  for  cleanliness  in  the  dairies  supplying  Massachusetts.  In 
1905  he  appointed  one  State  Dairy  Inspector,  and  at  his  death  was  con- 
templating extending  the  State  inspection  to  out-of-State  dairies. 

When  asked  by  the  chairman  of  the  health  committee  of  the  Women's 
Municipal  League  what  they  could  do  to  help  him,  Dr.  Harrington  sug- 
gested that  they  assist  him  in  securing  the  passage  of  the  bill  which  he 
had  introduced.  Because  of  the  continued  failure  to  get  Dr.  Harrington's 
bill  through,  it  was  decided  to  form  a  State  organization,  which  subse- 
quently took  the  name  of  the  Massachusetts  Milk  Consumers'  Associa- 
tion. 

On  May  5,  1910,  a  joint  committee  of  the  Legislature  was  appointed 
to  investigate  the  milk  problem.  This  committee,  after  expressing  the 
necessity  for  a  central  authority  administrating  a  uniform  inspection  of 
the  places  where  the  milk  is  produced,  recommended  that  the  Dairy 
Bureau  investigate  the  subject.  Acting  on  this  recommendation  the 
Legislature  authorized  an  investigation  by  the  Dairy  Bureau  consisting 


48 

of  three  members,  of  which  Charles  M.  Gardner  is  chairman,  with  two 
experts,  Dr.  Milton  J.  Rosenau  and  George  H.  Ellis,  to  complete  the 
commission. 

This  commission  on  Jan.  2,  1911,  reported  a  bill  to  the  Legislature 
known  as  the  Gardner  bill.  The  commission  unanimously  found  that 
existing  conditions  were  a  menace  to  the  Massachusetts  milk  consumers 
and  an  unfair  burden  upon  the  Massachusetts  milk  producers. 

It  was  at  this  stage  that  the  Milk  Consumers'  Association  became 
active.  The  Ellis  bill  is  simply  the  Gardner  bill  with  practically  only 
one  substantial  change,  the  details  of  the  bills  being  in  most  cases  word 
for  word  the  same. 

Instead  of  having  the  mixed  board  both  pass  and  administer  regu- 
lations, as  in  the  Gardner  bill,  the  Ellis  bill  provided  that  while  the  mixed 
board  should  pass  the  regulations  the  administration  should  be  in  the 
hands  of  the  State  Board  of  Health  in  order  to  preserve  unity  in  health 
administration. 

There  were  some  other  changes  made  at  the  suggestion  of  the  milk 
inspectors  who  met  at  a  conference  called  by  the  association  for  the 
purpose  of  getting  their  ideas.  The  changes  made  at  their  request  were 
in  the  line  of  preserving  local  powers.  Everything  they  asked  for  was 
put  into  the  bill. 

The  bill  expressed  the  ideas  of  Dr.  Rosenau  and  Mr.  Ellis,  the  minority 
members  of  the  commission. 

The  efforts  of  the  association  have  always  had  the  support  of  the 
Massachusetts  Medical  Society  and  of  various  local  medical  societies 
and  innumerable  other  State  and  local  welfare  organizations. 

The  association  has  constantly  consulted  experts  on  the  subject 
throughout  the  country,  and  has  from  time  to  time  made  changes  in  the 
bill  at  the  suggestion  of  its  members  and  others,  going  as  far  as  possible 
to  remove  controversial  phrases. 

Many  efforts  have  been  made  to  come  to  a  common  understanding 
with  the  Grange,  the  Grange  usually  being  represented  by  Mr.  Howard 
on  such  occasions. 

The  association  has  never  taken  any  arbitrary  position  as  to  the  form 
of  the  bill,  only  insisting  on  the  central  principle  that  the  State  Depart- 
ment of  Health  should  have  legal  power  on  its  own  initiative,  in  places 
where  milk  is  produced  or  handled,  to  insist  upon  reasonable  cleanliness. 

In  years  past  a  great  many  local  labor  unions  indorsed  the  bill  advo- 
cated by  the  Consumers'  Association,  but  this  year  the  State  branch  of 
the  American  Federation  of  Labor  at  its  State  convention  made  the  fight 
for  clean  milk  legislation  its  own,  and  authorized  its  legislative  com- 
mittee to  introduce  what  was  afterwards  known,  and  properly  so,  as  the 
labor  clean  milk  bill.  It  was  an  entirely  different  bill  from  the  Ellis 
bill,  but  one  which  was  heartily  supported  by  the  Massachusetts  Milk 
Consumers'  Association.  The  members  of  the  association  voted  almost 
unanimously  on  a  referendum  to  support  the  labor  bill. 


49 

After  receiving  the  favorable  report  of  the  public  health  committee, 
it  was  passed  by  a  two-thirds  vote  of  each  house,  but  was  vetoed  by  the 
Governor. 

The  original  Ellis  bill  was  passed  in  the  first  }rear  of  the  association's 
campaign,  but  was  vetoed  by  Governor  Foss. 

D.    THE  STATE  GRANGE. 
Session  of  1911,  Worcester. 

In  view  of  all  the  aspersions  cast  upon  the  Grange  and  upon  the  farmers 
because  of  the  Ellis  bill  episode,  and  the  misstatements  of  people  whose 
conduct  cannot  be  attributed  to  ignorance,  it  seems  fitting  to  cause  this 
annual  session  of  the  Massachusetts  State  Grange  to  speak  clearly  and 
distinctly  on  the  subject  of  milk  inspection  and  concerning  the  Grange 
attitude  upon  health  matters  in  this  State.  There  are  exceptions  to 
every  class  as  to  every  rule,  but  as  a  whole  the  farmers  of  this  Com- 
monwealth are  as  eager  to  sell  clean,  wholesome,  properly  handled  milk 
as  any  consumer  is  to  buy  it;  they  are  as  truly  interested  in  the  health 
and  life  of  little  babies  as  are  the  philanthropists  of  any  city.  No  one 
in  this  State  will  more  quickly  condemn  a  filthy  and  disease-breeding 
stable  than  the  great  mass  of  our  farmers  themselves;  and  in  any  reason- 
able and  common-sense  undertaking  to  improve  the  health  conditions  of 
the  dairy  industry  they  will  lend  instant  and  earnest  co-operation. 

They  do  insist,  however,  that  those  who  essay  to  prescribe  the  con- 
ditions of  milk  production  must  at  least  be  able  to  recognize  a  cow  stable 
when  they  see  one,  and  must  understand  that  a  farmer  cannot  produce 
any  kind  of  milk,  not  to  mention  clean  milk,  unless  he  can  get  something 
near  100  cents  for  each  dollar  that  he  spends  to  produce  that  milk. 

Your  State  master  sincerely  trusts  that  this  body  will  in  no  uncertain 
tones  pledge  its  belief  in  and  its  support  for  such  measures,  wherever 
their  origin,  as  propose  to  continually  improve  health  conditions  in  our 
milk  supply,  by  the  only  means  that  will  ever  prove  effective,  so  well 
expressed  in  the  words  of  the  Chief  Executive  of  the  Commonwealth: 
"  What  we  need  is  to  penalize  the  farmer  a  little  less  and  encourage  him 
a  good  deal  more." 

Session  of  1912,  Springfield. 

Confirming  further  our  previous  State  Grange  attitude  on  the  whole 
milk  question,  we  may  well  emphasize  anew  our  emphatic  declaration 
of  one  year  ago,  —  that  the  final  answer  to  all  phases  of  the  milk  problem 
will  be  found,  and  speedily  found  if  sought,  in  the  disposition  to  pay  the 
farmer  a  fair  price  for  clean,  well-handled  milk,  based  on  the  belief  that 
milk  producers  of  Massachusetts  will  make  just  as  good  milk,  even  up 
to  the  certified  class,  as  the  consumers  want  to  pay  for.  This,  finally, 
is  the  essence  of  the  whole  question,  and  points  the  way  to  the  line  of 
milk  education  to-day  most  needed. 


50 


Session  of  1913,  Boston. 

In  all  the  maze  of  the  milk  situation  it  is  exceedingly  refreshing  to 
find  some  of  the  milk  contractors  making  advances  to  the  producers  for 
a  graded  scale  of  prices,  paying  according  to  the  percentage  of  fat  value 
in  the  milk  and  the  degree  of  cleanliness  it  possesses.  This  is  highly 
significant  as  the  trend  of  the  times,  indicating  what  are  to  be  the  fines 
of  profitable  milk  production  for  the  future;  especially  so  because  this 
is  exactly  the  attitude  the  State  Grange  has  taken  for  three  consecutive 
years,  not  only  by  action  in  the  annual  session,  but  by  appeal  before 
the  Legislature,  —  that  the  farmer  will  produce  from  his  cows  just  as 
rich  milk  and  just  as  clean  milk  as  the  consumer  is  willing  to  pay  for; 
and  that  in  respect  to  cleanliness  the  farmer  is  already  spending  far  more 
in  equipment  and  in  care  than  the  consumer  does  pay  for.  Let  it  be 
hoped  that  a  graded  scale  of  milk  purchasing  will  ultimately  become 
general,  with  an  opportunity  afforded  the  ambitious  farmer,  at  a  price 
commensurate  with  the  cost  of  cleanliness,  to  produce  the  most  wholesome 
and  satisfactory  milk  it  is  possible  for  the  combination  of  clean,  healthy 
cows  and  clean,  honest  cow  owners  to  produce.  This  is  the  only  line  on 
which  milk  progress  can  ever  come,  and  that  most  people  are  coming  to 
see  this  fact  is  one  of  the  most  hopeful  signs  of  the  times  for  both  milk 
producers  and  milk  consumers. 

E.    MILK  AND  BABY  HYGIENE  ASSOCIATIONS. 

For  the  purpose  of  acquiring  information  as  to  the  work  done 
by  the  Milk  and  Baby  Hygiene  Associations,  a  letter  of  inquiry 
was  sent  to  the  following  associations:  Society  for  District 
Nursing,  Worcester;  Instructive  Nursing  Association,  New  Bed- 
ford; the  Lowell  Guild,  Lowell;  Visiting  Nurse  Association, 
Great  Barrington;  District  Nursing  Association,  Fall  River; 
Sanitary  Milk  Committee,  Lawrence;  Infant  Hygiene  Associa- 
tion, Holyoke;  Milk  and  Baby  Hygiene  Association,  Maiden; 
Baby  Clinic  Day  Nursery  Association,  Lynn;  and  Miss  Helen 
Dalton,  Fitchburg.     The  letter  was  as  follows:  — 

Will  you  kindly  send  me  for  use  in  this  Department  in  its  milk  investi- 
gation any  published  reports  or  data  you  may  have  in  regard  to  the  work 
being  done  by  your  society? 

Any  information  you  can  give  us  will  be  of  great  assistance. 

Replies  were  received  from  several  of  these  associations,  but 
none  of  them  had  anything  to  offer  in  the  way  of  the  informa- 


51 

tion  asked  for  except  the  Holyoke  and  Boston  Infant  Hygiene 
Associations.  From  the  first  we  received  their  first  annual  re- 
port published  in  1914.  This  report  is  very  interesting,  and 
contains  the  names  of  the  members  of  the  association,  the  by- 
laws, amount  of  money  spent  on  the  work,  and  is  descriptive 
in  a  general  way.  The  detailed  statement  of  the  Boston  asso- 
ciation follows:  — 

Statement  of  Dr.  J.  Herbert  Young. 

The  Milk  and  Baby  Hygiene  Association  of  Boston  was  organized  in 
1909.  The  purpose  of  the  association,  as  stated  in  the  first  annual  report, 
was  — 

1.  To  improve  the  milk  supply. 

2.  To  prevent  sickness  and  reduce  mortality  among  infants. 

3.  To  increase  the  health  and  vitality  of  children  and  their  mothers. 
The  methods  to  be  used  were  — 

1.  Encouragement  of  breast  feeding. 

2.  Distribution  of  clean  milk. 

3.  Maintenance  of  a  first-class  milk  modification  laboratory. 

4.  Maintenance  of  milk  stations  in  the  neediest  districts. 

5.  Instruction  of  high  school  girls,  mothers  and  fathers  in  the  care  of 
children. 

6.  Supervision  of  the  care  and  feeding  of  babies  by  skilled  physicians 
and  nurses  at  home  and  at  the  stations. 

7.  Conferences,  lectures,  exhibits  and  publications  for  milk  consumers. 

8.  Co-operation  with  public  health  authorities. 

9.  Researches  in  bacteriology,  biochemistry  and  sociology  with  reference 
to  infant  mortality. 

The  purpose  of  the  association  remains  the  same;  our  object  is  to 
keep  well  babies  well.  The  methods  used,  while  essentially  the  same, 
have  been  changed  somewhat  to  meet  existing  circumstances.  It  has 
been  our  experience,  as  time  goes  on,  that  in  our  work  as  applied  to  the 
individual  baby,  milk  assumes  lesser  and  hygiene  assumes  greater  im- 
portance. This  does  not  mean,  however,  that  the  association  does  not 
continue  to  have  an  active  interest  in  all  phases  of  the  milk-  question 
as  applied  to  infants. 

The  field  activities  of  the  association  are  carried  on  from  12  milk 
stations.  From  these  stations  we  cared  for,  in  1915,  4,800  babies.  Of 
these  babies  about  50  per  cent,  were  entirely  breast  fed,  30  per  cent, 
partially  breast  fed  and  20  per  cent,  entirely  bottle  fed. 

Bids  are  annually  requested  for  the  milk  sold  at  the  milk  stations. 
The  milk  at  the  present  time  is  supplied  by  D.  Whiting  &  Sons.  This 
milk  is  sold  to  the  mothers  at  cost.    Milk  modified  at  the  laboratory  of 


52 


D.  Whiting  &  Sons,  according  to  three  formulae  recommended  by  the 
association,  —  certified  milk,  inspected  whole  milk  and  fat-free  milk,  — 
is  provided.  The  modifications  are  made  from  milk  certified  by  the 
Medical  Milk  Commission  of  Boston.  The  certified  milk  is  certified  by 
the  Medical  Milk  Commission  of  Boston. 

The  whole  milk  and  fat-free  milk  is  of  the  grade  known  as  inspected. 
This  milk  comes  from  dairies  which  show  a  score  on  the  United  States 
government  score  card  between  75  and  80  points.  The  cows  are  annually 
subjected  to  the  tuberculin  test.  The  milk  is  pasteurized  at  a  temperature 
of  145°  for  thirty  minutes. 

During  the  month  of  December,  1915,  494  quarts  of  modified  milk, 
57  quarts  of  certified  milk,  5,414  quarts  of  inspected  whole  milk  and 
31  quarts  of  fat-free  milk  were  sold  at  the  12  milk  stations. 

While  we  believe  that  the  best  food  for  a  bottle-fed  baby  is  the  freshest, 
cleanest  and  purest  cow's  milk  that  it  is  possible  to  procure,  we  believe 
that  the  milk  sold  by  our  association,  or  any  milk  of  equal  grade,  is  a 
safe  food  for  infants. 

F.  CITY  OF  BOSTON  HEALTH  DEPARTMENT. 

Eugene  R.  Kelley,  M.D.,  Chairman,  Milk  Board,  State  Department 
of  Health,  State  House,  Boston. 

Dear  Doctor:  —  In  reply  to  your  communication  of  the  9th  instant, 
requesting  an  expression  of  my  opinion  on  the  present  status  of  the  milk 
situation,  I  would  say  that  this  Department  has  always  kept  in  mind 
the  sanitary  aspect  of  this  problem,  never  investigating  the  economic 
or  political  sides,  and  forbidding  the  employees  of  the  Department  from 
doing  so. 

Boston  is  expending  large  sums  of  money  to  improve  the  milk  supply 
of  this  city,  and  the  so-called  metropolitan  district  of  Boston  has  been 
reaping  the  benefit  of  this  inspection  without  expense  to  those  cities  and 
towns  in  the  district.  This  is  manifestly  unfair  to  Boston,  but  we  do 
not  complain,  as  under  the  present  methods  of  inspection  it  cannot  very 
well  be  avoided. 

In  my  opinion  the  inspection  of  the  production,  handling  and  trans- 
portation of  milk  is  largely  an  interstate  problem,  as  about  92  per  cent, 
of  the  milk  sold  in  Boston  comes  from  without  the  State,  and  should 
be  supervised  by  the  Federal  authorities.  As  the  government  has  refused 
to  assume  this  responsibility,  owing  to  lack  of  money  to  carry  on  the 
work,  the  duty  should  devolve  on  some  central  State  authority,  preferably 
the  State  Department  of  Health. 

If  the  State  Department  were  to  take  over  this  work  it  would  do  away 
with  a  great  amount  of  duplication  in  inspections  and  issuances  of  permits. 
You  are  thoroughly  conversant  with  the  present  law  regarding  the 
issuing  of  milk  permits,  so  I  will  not  go  into  that  phase  of  the  subject, 
except  to  say  that  if  a  central  State  authority  had  complete  supervision 


53 

over  these  permits  it  would  clarify  the  situation  wonderfully.  It  would 
also  help  the  producer,  as  he  would  have  only  one  inspecting  authority 
to  satisfy,  instead  of  three  or  four,  as  at  present. 

Local  authorities  should  have  complete  control  over  the  inspection 
and  handling  of  milk  within  the  limits  of  their  respective  cities  and  towns. 
The  law,  or  statute  requirements  as  to  standards,  etc.,  places  that  au- 
thority in  their  hands  at  present. 

I  believe  in  pasteurization  of  all  milk,  except  certified  milk,  under 
proper  supervision  by  the  local  authorities  of  the  cities  and  towns  where 
the  milk  is  offered  for  sale. 

Yours  very  truly, 

F.  X.  Mahoney, 
Health  Commissioner. 


G.    MASSACHUSETTS  STATE  BOARD  OF  AGRICULTURE. 

Massachusetts  is  peculiarly  located  in  relation  to  other  States  of  the 
New  England  group.  With  only  two  others  smaller,  and  surrounded  by 
them  all,  with  New  York  on  the  west,  it  is  the  natural  market  for  the 
group,  as  next  to  Rhode  Island  it  is  the  most  densely  populated  State 
in  the  United  States. 

Once  Boston,  which  is  now  the  great  milk  market  of  New  England, 
produced  its  own  milk  supply.  Then  as  the  city  grew,  and  demanded 
among  other  things  fresh  vegetables,  the  cows  were  pushed  out  to  the 
near-by  towns,  and  dairying  went  on  until  again  the  pressure  for  different 
kinds  of  agriculture  was  felt,  and  always  dairying,  which  was  considered 
a  more  extensive  type  of  agriculture,  depending  on  large  pastures  and 
lands  to  grow  cheap  forage,  was  pushed  further  from  the  central  base, 
and  Boston  has  had  to  draw  its  milk  supply  first  from  the  20-mile  radius, 
then  50,  then  100,  and  now  much  of  the  supply  comes  from  over  200 
miles.  What  is  true  of  Boston  has  been  true  in  a  measure  of  many  of 
the  smaller  cities;  but  many  of  these  latter,  owing  to  their  proximity 
to  the  farm  lands,  have  done  much  to  encourage  the  dairy  industry 
near  by,  and  are,  therefore,  supplied  with  a  better  grade  of  milk  than  is 
usually  sold  in  the  Boston  market,  where  now  a  more  discriminating 
public  is  demanding  that  its  milk  supply  be  drawn  from  sources  near 
the  consumption  line,  and  under  conditions  upon  which  it  desires  to 
impose  restrictions  which  are  bound  to  increase  the  cost  of  production, 
as  well  as  that  of  transportation  and  distribution. 

Massachusetts  agriculture  has  seen  great  changes  in  the  past  one 
hundred  years,  chiefly  owing  to  the  severe  competition  of  States  more 
favored  than  we  are  by  climate,  soil  or  transportation  facilities  for  the 
production  and  distribution  of  some  particular  crop;  but  in  spite  of  the 
loss  of  some  crops  and  a  great  reduction  in  dairying,  the  State  has  ad- 
vanced steadily  in  the  value  of  its  agricultural  products  since  1870,  as 
the  following  figures  will  show :  — 


54     . 

1879, $24,160,881 

1889 28,072,500 

1899, 42,298,274 

1909 60,000,000 

Market  gardening,  fruit  growing  and  the  production  of  special  green- 
house crops  have  in  many  instances  taken  the  place  of  dairying  on  our 
farms,  and  particularly  so  near  the  cities,  where  it  has  been  possible  to 
obtain  manure  from  city  stables  to  conduct  these  operations. 

With  the  very  acute  fertilizer  situation  our  farmers'  attention  is  more 
forcibly  drawn  to  the  general  problem  of  keeping  up  soil  fertility,  and 
were  this  situation  to  continue  for  long,  undoubtedly  it  would  have  a 
very  great  effect  in  restocking  with  dairy  animals  many  of  the  farms  of  the 
State.  That  there  is  a  desire  on  the  part  of  many  farmers  to  put  cattle 
back  on  the  farm  is  apparent,  and  there  is  a  decided  feeling  in  many 
sections  that  the  cow  is  a  necessity  in  our  agriculture;  that  milk  should 
be  treated  as  a  by-product;  that  we  should  raise  more  pure-bred  stock 
in  this  State;  and  that  all  of  our  dairymen  should  raise  their  own  stock 
and  not  depend  upon  those  shipped  here. 

With  our  great  resources  in  undeveloped  land,  salt  and  fresh  marshes 
for  growing  hay,  upland  pastures  now  growing  up  to  brush,  and  much 
valley  land  still  unproductive,  we  certainly  have  a  chance  to  produce 
all  the  milk,  cream  and  butter  that  we  consume.  That  we  shall  produce 
it  some  time  is  apparent,  but  with  present  conditions  as  they  are,  with 
our  best  markets  flooded  with  milk  produced  in  more  natural  dairy 
sections  than  ours,  and  hauled  to  these  markets  as  cheaply  as  ours,  Massa- 
chusetts' problem  is  one  of  producing  a  superior  article  which  will  be 
called  for  in  our  markets  in  preference  to  any  other. 

That  the  dairy  problem  is  no  new  one  to  our  people  is  apparent  from 
the  following,  taken  from  the  report  of  the  secretary  of  the  State  Board 
of  Agriculture  for  1884:  — 

The  production  of  milk  to  supply  our  towns  and  cities  is  a  branch  ot  husbandry 
that  in  late  years  has  not  been  satisfactory;  the  farmers  have  allowed  shrewd 
contractors  to  control  the  supply  and  sale  of  milk,  and  have  accepted  prices  lower 
than  the  cost  of  production. 

In  a  way  it  is  to  the  credit  of  our  farmers  that  they  have  gone  out  of 
the  dairy  business  rather  than  produce  an  article  for  which  they  did 
not  receive  a  profit;  but  the  most  vital  question  is  a  readjustment  of 
our  agriculture,  and  a  readjustment  in  which  the  dairy  cow  will  play  a 
prominent  part.  Diversified  agriculture  is  bound  to  become  more  common 
with  the  exception  of  very  favorable  localities,  in  which  rotation  of  crops, 
together  with  animal  husbandry,  will  be  practiced,  and  a  business  built 
upon  quality  and  freshness  of  our  products  will  take  the  place  of  the 
now  long-distance  shipments  which  are  so  common  in  our  markets. 


55 


H.    MASSACHUSETTS    STATE    DEPARTMENT    OF    ANIMAL 

INDUSTRY. 

State  House,  Boston,  Sept.  15,  1915. 

Dr.  Eugene  R.  Kellet,  Chairman  of  Milk  Board,  State  Department 

of  Health. 

Deae  Sir  :  —  Your  letter  of  September  9  at  hand,  and  in  reply  will 
furnish  you  with  what  information  I  can  on  the  different  subjects 
mentioned. 

On  account  of  the  prevalence  of  foot-and-mouth  disease  this  past 
season  the  annual  inspection  of  animals  and  premises  by  the  local  in- 
spectors of  animals  throughout  the  State  was  abandoned.  This  animal 
inspection  is  generally  recorded  during  the  early  spring  months,  when 
the  animals  are  all  in  the  barns  and  can  be  more  conveniently  examined, 
and  in  order  that  disease  which  may  have  been  influenced  by  the  housing 
of  the  animals  during  the  winter  months  may  be  recognized.  On  account 
of  the  danger  of  spreading  foot-and-mouth  disease  by  the  medium  of 
the  local  inspectors  of  animals  going  from  farm  to  farm,  and  also  on 
account  of  the  apprehension  of  cattle  owners  of  this  danger  of  spread  of 
the  disease,  we  decided  that  no  inspection  should  take  place  this  year. 

The  next  inspection  will  undoubtedly  be  ordered  some  time  during 
the  coming  winter,  and  at  the  end  of  that  inspection  a  much  better  general 
opinion  of  conditions  of  animals  and  premises  can  be  rendered  than  at 
the  present  time. 

If,  upon  examination  of  the  animals  on  a  certain  premises  by  an  in- 
spector, he  has  reason  to  suspect  the  presence  of  any  contagious  disease, 
he  is  ordered  to  quarantine  such  animal  or  animals,  and  send  duplicate 
copy  of  such  quarantine  to  this  office. 

I  am  enclosing  to  you  a  blank  form  used  by  the  local  inspector  of 
animals  at  the  time  of  their  examination,  in  order  that  you  may  see  the 
information  they  are  expected  to  return  to  us.  A  copy  of  their  report  is 
left  with  the  owner  of  the  animal,  another  one  retained  by  the  inspector, 
and  the  full  record  sent  to  this  office.  At  the  time  a  copy  of  this  record 
is  left  with  the  owner  of  the  premises,  such  recommendations  for  im- 
proved conditions,  if  any,  as  are  necessary  in  the  opinion  of  the  inspector, 
are  brought  to  the  attention  of  the  owner  by  the  inspector,  and  the 
owner  is  requested  to  make  such  improvements.  A  later  visit  is  made 
by  the  local  inspector,  at  which  time,  if  conditions  are  found  to  be  de- 
cidedly improved,  the  report  submitted  to  this  Department  above  re- 
ferred to  credits  the  owner  with  the  conditions  found  on  the  second  visit, 
and  in  most  cases  we  find  that  the  owners  carry  out  the  recommenda- 
tions made  by  the  inspectors. 

As  a  result,  many  of  the  cases  that  under  a  former  plan  would  have 
been  called  to  the  attention  of  the  district  agents  of  our  department 
are  satisfactorily  disposed  of  locally,  but  if  not  so  disposed  of  our  district 


56 


agent  is  sent  to  the  premises,  and  this  Department's  supervision  is  directly 
given  to  such  premises,  and  frequent  visits  made  until  they  are  placed 
in  a  satisfactory  condition. 

All  cattle  over  six  months  of  age  coming  into  Massachusetts  from 
any  point  without  the  State,  if  not  intended  for  immediate  slaughter, 
are  according  to  law  tuberculin  tested  by  an  agent  of  this  Department, 
unless  accompanied  by  a  certificate  of  test  made  by  a  man  approved 
by  the  officials  of  the  State  wherein  the  shipment  originates.  All  animals 
reacting  to  this  test  are  destroyed. 


For  the  Year  ending  Dec.  1,  191 4. 
Number  of  cattle  tuberculin  tested  by  agents  of  this  Department  or  ap 

proved  veterinarians  outside  of  the  State  were 
Released  at  Brighton,  . 
Released  at  other  points, 
Released  for  slaughter, 
Condemned  at  Brighton, 
Condemned  at  other  points, 
Permit-to-kill  warrant  issued, 


23,645 

17,485 

5,472 

2 

587 

86 

13 


The  above  figures  relate  only  to  cattle  brought  into  Massachusetts 
from  without  the  State. 

Of  the  17,411  tested  at  the  quarantine  station  in  Brighton  587,  or  3J 
per  cent.,  reacted  to  the  tuberculin  test,  and  only  one  of  such  reactors 
failed  to  show  lesions  of  tuberculosis  on  post-mortem  examination,  which 
is  made  in  every  case. 

The  following  figures  show  the  number  of  neat  cattle  quarantined  by 
local  inspectors  of  animals  within  the  State,  for  which  number  warrants 
were  issued  by  this  Department,  and  disposition  made  of  the  animals :  — 


Massachusetts  Cattle. 
Total  number  of  cattle  quarantined  or  reported  for  examination  during 
the  year,    ........ 

Number  released,  ....... 

Number  condemned,  killed  and  paid  for, 

Number  condemned  and  killed,  in  process  of  settlement, 

Number  permit  to  kill,  paid  for,       .... 

Number  permit  to  kill,  no  award,    .... 

Number  died  in  quarantine,  no  award, 


2,259 
288 
880 
141 

63 
174 

36 


Cattle  from  without  the  Slate. 
Number  released,  ........ 

Number  condemned  and  killed,  no  award, 

Number  condemned  and  killed,  no  lesions  found,  paid  for, 

Number  in  process  of  settlement,     . 


12 

654 

6 

5 


In  addition  to  the  2,259  head  of  cattle  disposed  of  as  above,  133  cattle 
and  27  swine  have  been  reported  by  butchers,  Tenderers  and  boards  of 
health  as  having  been  found  tuberculous  at  time  of  slaughter,  all  of 
which  were  rendered. 


57 

I  quote  you  section  31,  chapter  90,  Revised  Laws,  as  amended,  which 
restricts  the  use  of  tuberculin  as  a  diagnostic  agent :  — 

Tuberculin  as  a  diagnostic  agent  for  the  detection  of  tuberculosis  in  domestic 
animals  shall  be  used  only  upon  cattle  brought  into  the  commonwealth  and  upon 
cattle  at  Brighton,  Watertown,  and  Somerville;  but  it  may  be  used  as  such  diag- 
nostic agent  on  any  animal  in  any  other  part  of  the  commonwealth,  with  the 
consent  in  writing  of  the  owner  or  person  in  possession  thereof,  and  upon  animals 
which  have  been  condemned  as  tuberculous  upon  physical  examination  by  a 
competent  veterinary  surgeon.  Such  tests  by  the  use  of  tuberculin  shall  be  made 
without  charge  to  citizens  of  the  commonwealth,  and  in  all  other  caser  the  expense 
of  such  tests  shall  be  paid  by  the  owners  oi  such  animals  or  by  the  person  in  posses- 
sion thereof. 

The  activities  of  the  local  insDectors  of  animals  are  not  limited  to 
their  annual  cattle  inspection.  On  finding  an  animal  which  to  them 
seems  to  be  probably  diseased,  they  quarantine  the  same,  and  return  a 
duplicate  to  this  office.  A  warrant  or  killing  order  is  then  made  out,  and 
one  of  our  district  agents,  or  an  outside  veterinarian  who  acts  as  our 
agent,  is  charged  with  the  execution  of  the  warrant.  If,  on  physical 
examination  the  animal  is  found  to  be  diseased,  it  is  condemned  and 
killed,  and  report  made  to  this  office  of  the  lesions  found  on  post-mortem 
examination. 

Following  the  disposal  of  a  case  of  tuberculosis,  the  owner  is  required 
to  disinfect  the  premises  according  to  our  instructions,  and  his  claim 
for  reimbursement  for  the  death  of  the  animal  is  not  paid  until  report 
is  on  file  in  this  office  that  the  disinfection  has  been  satisfactorily  com- 
pleted. 

I  am  about  to  institute  the  practice  of  careful  physical  examination 
of  aU  the  animals  in  the  herd  from  which  an  animal  afflicted  with  tuber- 
culosis has  been  condemned  by  this  Department.  In  my  opinion  this 
wiU  bring  to  notice  a  no  inconsiderable  number  of  diseased  animals  which 
otherwise  might  have  escaped  notice  for  a  greater  or  less  period,  during 
which  time  they  were  acting  as  spreaders  of  the  disease. 

The  percentage  of  Massachusetts  cattle  tested  with  tuberculin  is 
necessarily  small,  and  it  is  impossible  to  get  at  the  correct  statistics. 
This  Department  tests  Massachusetts  cattle  with  tuberculin  only  upon 
voluntary  request  of  the  owner,  and  private  tests  which  are  made  are 
not  in  very  many  cases  reported  to  this  office,  so  that  no  means  are  at 
hand  for  obtaining  information  as  regards  the  percentage  of  the  State's 
cattle  which  are  tuberculin  tested. 

Whether  or  not  a  tuberculin  test  should  be  compulsory  is  a  large 
question,  and  open  to  a  great  deal  of  argument  pro  and  con.  Compulsory 
tuberculin  test  was  inaugurated  in  this  State  some  twenty  years  ago, 
but  it  was  not  carried  very  far  before  the  farmers  rose  en  masse  against 
it.  Tuberculosis  was  then  so  rampant  among  the  cattle  of  this  State 
that  in  many  instances  as  high  as  30  to  50  per  cent,  of  the  cattle  were 
destroyed  as  a  result  of  the  tuberculin  test,  and  the  carcasses  became 
a  total  loss. 


58 

In  my  opinion  there  is  a  gradual  improvement  from  year  to  year  in 
the  percentage  of  cases  of  tuberculosis  among  our  cattle,  and  with  what 
improvements  we  make  in  the  control  of  this  disease  I  think  the  general 
situation  is  found  to  gradually  become  better. 

On  the  appearance  of  foot-and-mouth  disease  in  this  State  last  Novem- 
ber the  great  market  for  milch  cows,  viz.,  Brighton  Stock  Yards,  was 
immediately  closed,  and  remained  closed  until  Sept.  1,  1915,  when  modi- 
fication of  the  quarantine  was  allowed,  so  that  there  could  be  received  at 
these  premises  cattle  from  the  States  of  Massachusetts,  Maine,  Vermont 
and  New  Hampshire.  Cattle  from  all  other  States  in  the  Union  are 
prohibited  from  entering  the  Brighton  Stock  Yards  unless  intended 
for  immediate  slaughter,  and  all  cattle  received  from  any  other  sections 
of  the  country  than  those  States  mentioned  are  obliged  to  remain  in 
quarantine  at  the  point  of  arrival  until  released  by  an  agent  of  this  De- 
partment, and  at  the  present  time  this  limit  of  quarantine  is  fifteen  days, 
so  that  in  case  the  animals  have  picked  up  this  infection  en  route,  sufficient 
time  will  elapse  while  in  quarantine  for  them  to  show  clinical  symptoms, 
and  the  disease  will  therefore  be  confined  to  those  premises.  No  cattle 
are  received  anywhere  in  Massachusetts  from  any  point  other  than  what 
is  designated  as  "free  area"  by  the  United  States  Department  of  Agri- 
culture. All  premises  on  which  foot-and-mouth  disease  existed  during 
the  recent  epidemic  are  still  under  quarantine,  and  animals  go  to  and 
from  such  premises  only  on  permit  of  this  Department. 

Regarding  the  health  of  cattle  in  different  sections  of  the  State,  a 
larger  number  of  cases  of  disease  are  found  in  the  middle  and  eastern 
sections.  Very  little  contagious  disease  of  any  kind  is  found  in  the  Cape 
district,  and  in  that  portion  of  the  State  west  of  the  Connecticut  River. 

As-  you  asked  for  a  personal  opinion  regarding  physical  examination 
of  animals,  I  would  say  that  it  is  my  belief  that  a  more  careful  and  more 
frequent  physical  examination  would  certainly  tend  toward  an  improve- 
ment in  the  health  conditions  as  viewed  from  the  standpoint  of  the 
products  of  the  animal  industry,  whether  that  product  be  milk  or  meat. 

Very  truly  yours, 

Lester  H.  Howard, 

Commissioner. 

I.    CATTLE  BREEDERS'  ASSOCIATIONS. 

Appended  is  a  list  of  the  replies  from  several  cattle  breeders' 
associations  in  response  to  request  for  information  as  to  their 
opinion  on  the  question  of  selling  milk  on  a  basis  of  its  food 
value. 

Mr.  Williams  attended  a  meeting  of  the  New  England  Hol- 
stein  Friesian  Breeders'  Association,  and  asked  for  an  opinion 
on  the  matter  of  selling  milk  on  a  basis  of  its  food  value.    The 


59 

members  of  the  association  would  not  give  a  frank  opinion, 
but  two  or  three  members  said  that  the  association  had  always 
stood  for  clean,  pure  milk.  Mr.  Williams  was  led  to  believe 
that  they  were  opposed  to  any  system  whereby  milk  would  be 
sold  on  a  basis  of  its  food  value.  Several  of  the  members  made 
claims  that  Holstein  milk  was  a  better  milk  for  infants  or  in- 
valids than  any  other,  and  that  it  was  the  best  substitute  for 
mother's  milk  that  could  be  found.  Professor  Hills  in  an  ad- 
dress at  the  meeting  said  that  he  had  carried  on  a  great  number 
of  experiments,  and  had  come  ,to,thef  conclusion  that  Holstein 
milk  was  the  nearest  to  the  'pr^esesfc  milk  for  infant  feeding, 
but  was  no  better  than  Jersey  or  Guernsey  milk  that  was  re- 
duced to  the  same  amount  of  fat,  solids,  sugar,  etc.  Professor 
Hills  said  that  his  experiments  had  been  carried  on  on  a  large 
number  of  baby  pigs. 

No  answer  has  been  received  from  the  American  Holstein 
Friesian  Association  in  response  to  our  letter,  as  the  secretary 
could  not  say  how  they  felt  in  the  matter,  but  he  said  he  would 
take  it  up  at  some  future  meeting.  All  of  the  other  associa- 
tions that  have  answered  have  expressed  their  approval  of  the 
idea  of  selling  milk  on  a  basis  of  its  food  value. 

As  far  as  the  Jersey  breed  of  cattle  is  concerned,  nothing  would  please 
us  better  than  to  see  milk  universally  sold  in  accordance  with  its  value 
as  food.     (American  Jersey  Cattle  Club,  R.  M.  Gow,  Secretary.) 

There  is  no  question  about  the  desirability  of  selling  milk  on  the  basis 
of  its  food  value.  Brown  Swiss  Breeders  are  in  favor  of  a  quality  test 
oh  milk.    (Brown  Swiss  Breeders'  Association,  H.  C.  Taylor,  Secretary.) 

The  question  has  never  been  discussed  by  the  Ayrshire  Breeders' 
Association  in  relation  to  selling  milk  on  its  food  value.  My  personal 
opinion  is  that  milk  should  be  sold  on  the  food  value  it  contains.  (Ayr- 
shire Breeders'  Association,  C.  M.  Winslow,  Secretary.) 

■  I  am  personally  a  great  believer  in  the  selling  of  milk  and  dairy  products 
according  to  their  value  as  food.  Why  should  not  the  same  be  done  as 
with  other  commodities?  (American  Guernsey  Cattle  Club,  W.  H. 
Caldwell,  Secretary.) 

I  was  always  of  the  belief  that  all  dairy  products  should  be  sold  as 
nearly  as  possible  on  their  basis  of  food  value.  (Red  Polled  Cattle  Club, 
H.  A.  Martin,  Secretary.) 


60 


PART   III.     FACTS   OF  PRODUCTION,   PROCESSING  AND 
MARKETING. 


A.    SUMMARY    OF    MILK    BOARD'S    OWN    DAIRY    INSPEC- 
TIONS. 

The  Milk  Board  visited  various  sections  of  Massachusetts, 
Maine,  New  Hampshire,  Vermont,  Connecticut  and  New  York 
and  the  Province  of  Quebec  in  their  investigation  of  the  milk 
problem  as  it  pertains  to  the  State  of  Massachusetts.  .  More 
than  300  dairies  were  investigated,  and  although  this  number 
represents  approximately  only  2  per  cent,  of  the  total  number 
of  dairies  within  the  State,  their  location  and  type  make  them 
reasonably  representative  of  the  whole.  The  committee  started 
its  work  in  the  Berkshire  section  of  the  State  in  April,  1915. 
In  May  33  dairies  were  investigated  in  the  following  towns: 
Truro,  North  Truro,  Orleans,  East  Orleans,  Eastham,  Barn- 
stable and  Sandwich.  There  were  a  total  of  146  cows  kept  on 
these  dairies,  producing  approximately  1,429  quarts  of  milk  per 
day.  The  farms  were  on  the  average  neat  and  clean.  Many  of 
the  barns  were  old  but  kept  in  reasonably  good  condition.  Only 
in  one  or  two  instances  were  they  of  a  low  standard.  Cooling  and 
icing  were  done  in  a  fairly  satisfactory  manner.  Several  farmers 
state  that  there  is  no  demand  for  winter  milk,  and  are  consider- 
ing the  keeping  of  cows  only  for  the  summer  trade.  The  aver- 
age price  for  milk  at  wholesale  is  6  to  7  cents  per  quart,  and 
at  retail,  10  to  12  cents  per  quart.  Some  dairies  sell  at  the 
door  for  from  7  to  9  cents  per  quart.  Mr.  P.,  a  small  producer, 
wholesales  at  6  cents  per  quart,  and  says  that  "there  is  no 
money  in  the  business."  Another  dairyman  who  retails  his 
product  says  that  the  business  pays  only  when  milk  sells  at  10 
cents.  There  were  four  herds  in  this  section  tuberculin  tested. 
Dairies  were  subject  to  local  and  State  inspection,  and  no  com- 
plaints were  heard  regarding  it.  Fifteen  dairies  in  Truro,  sup- 
plying milk  to  Provincetown,  were  inspected  and  scored,  the 
old  form  of  score  card  being  used.    For  methods  they  averaged 


61 

73  of  the  perfect  score  and  for  cleanliness,  72.  Two  instances 
were  noted  where  former  inspection  by  the  State  Department 
of  Health  had  been  of  service.  A  man  who  owned  the  dairy 
which  gave  the  highest  score  stated  that  the  conditions  found 
were  due  to  suggestions  made  by  the  inspector  of  the  Depart- 
ment. Another  who  had  been  annoyed  with  moisture  collecting 
upon  the  ceiling  and  falling  down  said  that  upon  advice  of  the 
inspector  of  the  State  Department  of  Health  the  condition  had 
been  removed.  Conditions  of  the  dairies  in  this  part  of  the 
State  are  rather  different  than  those  elsewhere.  There  are  fewer 
cows,  and  milk  is  as  a  rule  delivered  to  consumers  by  the  owner 
of  the  dairy  immediately  after  milking,  and  very  frequently 
without  cooling. 

The  district  visited  about  Lynn  included  this  city  and  Saugus, 
Melrose,  Lynnfield,  Peabody  and  Salem.  Thirteen  dairies  were 
visited.  A  total  of  462  cows  were  kept.  The  conditions  in  gen- 
eral were  good.  Poor  drainage  conditions  were  noted  in  two, 
and  a  few  did  not  have  separate  milk  rooms.  Ou  several  dairies 
only  a  few  cows  were  kept  principally  for  the  purpose  of  pro- 
ducing fertilizer.  Such  places  were  engaged  in  market  garden- 
ing, the  dairy  end  being  more  or  less  a  side  line.  On  one  of 
the  places  the  cattle  were  regularly  inspected  by  veterinaries, 
and  the  men  employed  subjected  to  physical  examination  by 
physicians.  Milk  retails  for  from  7  to  12  cents  per  quart,  and 
wholesales  at  45  to  50  cents  per  can  in  winter  and  from  42 
to  43  cents  in  summer.  Mr.  B.,  who  has  18  cows,  says  there 
is  no  money  in  the  business  at  these  prices.  Mr.  S.,  having 
50  cows  and  selling  milk  at  8  cents  retail,  says  the  milk  busi- 
ness is  not  so  profitable  as  it  used  to  be  because  grain  and  cows 
cost  so  much.  In  Methuen,  Bedford  and  Concord  9  dairies 
were  visited,  with  a  total  of  375  cows  kept.  The  conditions 
found  were  generally  satisfactory.  Milk  from  these  dairies  re- 
tails for  from  8  to  12  cents  per  quart.  Mr.  B.,  producing  160 
quarts  daily,  all  of  which  he  retails  at  8  cents  per  quart,  said 
that  the  milk  should  bring  9  cents  per  quart  to  make  the  busi- 
ness a  paying  proposition.  All  these  dairies  and  those  included 
in  the  Lynn  district  are  subject  to  local  and  State  inspection. 
There  appears  to  be  no  objection  to  such  inspection;  no  com- 
plaints were  made.     Mr.  H.,  who  keeps  50  head  of  cattle  and 


62 

produces  300  quarts  of  milk  daily,  said  that  proper  inspection 
would  be  a  good  thing  if  the  inspector  understood  the  farmer's 
problem.  Representatives  of  the  committee  visited  the  district 
about  Fitchburg,  which  included,  beside  the  city,  the  towns  of 
Westminster  and  Winchcndon.  Eight  dairies  were  visited  upon 
which  were  kept  a  total  of  205  cows,  producing  approximately 
1,509  quarts  of  milk  daily.  One  of  the  dairies  produced  cream 
and  wholesaled  in  the  city  of  Fitchburg.  All  the  dairies  visited 
presented  very  satisfactory  conditions.  They  were  subject  to 
frequent  local  inspection,  which  was  based  upon  education 
rather  than  coercion.  Commendable  conditions  were  noted  on 
dairies  in  Winchendon.  Only  two  dairies  wholesaled  their  milk 
and  one  wholesaled  cream.  The  prices  received  by  these  dairies 
were  40  cents  per  can  for  milk  and  50  cents  per  quart  for 
cream.  Milk  retails  in  Fitchburg  for  from  8  to  12  cents  per 
quart,  while  in  Winchendon  the  maximum  is  8  cents  per  quart. 
Mr.  M.  of  Winchendon,  whose  methods  and  equipment  gave  an 
excellent  score,  93,  thinks  that  10  cents  per  quart  would  be  a 
fair  price. 

In  the  Berkshire  district  which  included  Richmond,  West 
Stockbridge,  Great  Barrington,  Egremont,  New  York  State, 
Stockbridge,  Pittsfield  and  Cheshire,  15  dairies  were  visited, 
also  one  creamery  keeping  333  head  of  cattle  and  33  young 
stock.  In  many  of  the  farms  visited  conditions  were  found  to 
be  fairly  good.  Some  in  addition  to  dairy  farming  were  en- 
gaged in  various  side  lines,  such  as  poultry,  pork  raising  and 
summer  boarders.  Milk  from  this  section  is  shipped  into  Pitts- 
field,  Mass.,  and  New  York.  Mr.  S.,  who  operates  a  100-acre 
farm,  retails  the  milk  at  8  cents  per  quart.  He  says  that  were 
it  not  for  the  fact  that  he  and  his  wife  do  all  the  work  he 
could  not  stay  in  the  business.  One  of  the  troubles  he  says 
has  been  multiplicity  of  inspection.  A  Mr.  C,  operating  a 
200-acre  farm,  says  that  milk  should  bring  5  cents  per  quart 
at  the  farm  in  order  to  pay.  Butter  produced  in  this  section 
brings  at  retail  35  to  40  cents  per  pound.  Mr.  M.,  who  has 
a  275-acre  farm  and  is  engaged  in  this  business,  states  that 
butter  could  not  be  produced  for  less  than  the  prices  given  and 
allow  a  living  margin.  The  dairies  are  subject  to  local  inspec- 
tion. Inspectors  also  come  in  from  Pittsfield  and  New  York 
to  dairies  supplying  milk  to  these  places. 


63 

The  committee  visited  80  dairies  in  the  Deerfield  valley,  in- 
cluding the  following  towns:  Ashfield,  Buckland,  Conway,  Shel- 
burne,  Charlemont,  Heath  and  Whitingham,  Vt. 

The  dairies  were  found  to  be  in  a  very  poor  condition.  On 
a  total  score,  10  per  cent,  scored  below  40  and  only  1  per  cent, 
above  70.  The  Milk  Inspection  Association  had  recommended 
that  permits  be  refused  to  any  dairies  scoring  below  50.  Nearly 
all  the  dairies  use  ice  for  cooling.  The  milk  is  kept  in  40- 
quart  cans,  and  is  collected  every  day,  or  every  other  day  in 
some  cases,  and  delivered  to  the  railroad  depot,  where  it  is 
kept  without  being  iced  until  placed  on  the  train.  Some  of 
the  farmers  are  obliged  to  cart  their  milk  some  distance  and 
leave  it  on  the  platform  in  the  sun  until  the  collector  calls  for 
it.  A  number  of  Polish  people  have  bought  up  old  farms  in 
this  region  and  are  gradually  improving  them.  One  of  these, 
for  example,  presented  dirty  walls  and  floors,  with  manure 
piled  up  to  the  windows.  This  place  scored  48.7,  but  the  use 
of  ice  in  milk  house  brought  up  the  score.  On  another  place 
presenting  dirty  conditions  the  woman  who  was  interviewed 
stated  that  she  knew  the  stable  was  in  poor  condition,  but  the 
price  given  for  milk  was  insufficient  to  compensate  for  making 
any  improvements.  She  also  stated  that  the  Pole  who  col- 
lected the  milk  was  in  the  habit  of  measuring  it  by  means  of 
a  stick  which  he  wiped  sometimes  on  a  cloth,  sometimes  on 
his  overalls  and  sometimes  on  the  grass.  The  average  price 
paid  the  farmers  is  $1.55  per  100  pounds,  which  is  undoubtedly 
less  than  the  cost  of  production,  and  out  of  this  is  deducted 
the  cost  of  transportation.  One  farmer  stated  that  the  reason 
for  the  low  price  of  milk  was  due  to  the  inability  of  the  farmers 
to  hold  together.  Very  few  of  the  farmers  keep  more  than  10 
cows.  They  keep  only  a  sufficient  number  to  enable  them  to 
keep  up  the  farm,  the  principal  product  being  manure  and  the 
by-product  being  milk.  Inquiries  relative  to  any  systematic 
inspection  being  made  met  with  negative  replies.  The  only 
inspection  is  that  casually  done  by  the  man  representing  the 
milk  contractor  at  the  time  he  makes  his  visits  to  solicit  milk 
from  the  farmers.  The  character  of  some  of  these  dairies  war- 
rants the  statement  that  the  contracting  company  is  willing  to 
take  milk  from  any  dairy,  no  matter  what  condition  it  is  in. 
Dairies  were  visited  by  the  committee  in  the  towns  of  North 


64 

Charlestown,  Claremont,  Greenville,  Mason,  all  in  New  Hamp- 
shire, and  Wethersfield,  Vt.  Thirteen  dairies  were  inspected 
on  which  were  kept  a  total  of  150  cows,  producing  approxi- 
mately 131  cans  of  milk  per  day  which  was  shipped  into  the 
State  of  Massachusetts.  A  few  places  presented  fairly  good 
conditions,  while  in  others  various  objectionable  conditions  pre- 
vailed, such  as  poor  barns,  lack  of  proper  milk  rooms  or  suit- 
able places  to  handle  milk,  poor  methods  of  cooling  and  low 
standard  of  cleanliness.  Milk  is  wholesaled  at  25  to  32^  cents 
per  can.  A  Mr.  M.,  producing  8  cans  of  milk  per  day,  says 
that  the  laws  discourage  milk  production. 

Seven  dairies  at  Wethersfield,  Vt.,  were  visited,  where  a  total 
of  149  cows  were  kept,  producing  550  quarts  of  milk  per  day, 
all  of  which  was  shipped  into  Boston,  Mass.,  to  a  milk  con- 
tractor. Conditions  on  each  dairy  were  distinctly  bad.  The 
place  in  which  the  cows  were  kept  was  unfit  because  of  filthy 
and  wretched  drainage,  poor  light  and  ventilation  and  general 
filthy  conditions.  Some  of  the  most  filthy  conditions  of  all 
were  found  on  the  milk  collector's  farm,  this  man  being  em- 
ployed by  the  contracting  company  to  collect  the  milk  from 
the  farmers  and  ship  it  to  Boston.  Farmers  complained  of 
delay  in  collecting  and  shipping  the  milk,  one  farmer  stating 
that  the  milk  was  thirty-six  hours  old  before  it  was  shipped 
from  Claremont.  The  price  paid  the  farmers  for  milk  ranged 
from  28  to  33  cents  per  can.  One  farmer  preferred  to  sell  his 
milk  to  a  local  creamery.  The  wife  of  a  dairyman,  in  his  ab- 
sence, stated  that  her  husband  did  not  consider  there  was  any 
money  in  the  business  at  the  price  they  were  getting.  Others 
were  going  out  of  business  because  of  the  low  price  received. 
The  committee  were  of  the  opinion  that  milk  from  this  region 
should  not  be  permitted  to  enter  Massachusetts  or  any  other 
State  as  conditions  now  exist  on  the  farms. 

The  committee  visited  27  dairies  in  the  counties  of  Andros- 
coggin, Cumberland,  Kennebec,  Lincoln,  Sagadahoc  and  Waldo, 
Me.;  also  visited  the  plants  of  the  milk  contractors  in  this 
region  from  which  milk  is  shipped  into  Massachusetts,  the  prin- 
cipal one  of  which  is  the  Turner  Center  Dairying  Association. 
Of  the  27  dairies  visited,  22  sold  to  this  association,  4  to  two 
Massachusetts  contractors  and  1  to  the  Bangor  Creamery.    The 


65 

dairies  supplying  the  Turner  Center  Dairying  Association  were 
found  to  be  in  the  best  condition,  while  those  supplying  the 
Massachusetts  contractors  presented  nasty  conditions;  horse 
manure  was  used  in  gutter,  and  milk  was  found  cooled  in  tub 
of  water  near  pump  in  hot  weather  and  was  not  cooled  at  all 
in  cold  weather.  The  pasteurizing  plants  were  found  to  be  in 
a  very  good  sanitary  condition,  and  conducted  on  the  whole  in 
a  satisfactory  manner.  The  plants  visited  were  located  at  Au- 
burn, Wiscasset,  West  Benton  and  Unity.  The  pasteurizing 
plant  of  one  of  the  Massachusetts  contractors  at  Unity  was 
in  an  extremely  dirty  condition.  Pasteurization  in  this  plant 
is  supposed  to  be  carried  on  at  a  temperature  between  160  to 
170,  and  the  cream  is  held  for  thirty  minutes,  while  skimmed 
milk  is  not  held.  The  temperature  at  the  time  of  visit  regis- 
tered 172. 

The  Turner  Center  Dairying  Association  has  the  total  output 
of  between  4,200  and  4,300  farms  situated  in  Maine.  Of  this 
amount,  75  per  cent,  is  sold  in  Massachusetts.  Very  little  is 
sold  at  retail  in  Massachusetts  except  in  the  city  of  Lawrence. 
Mr.  Bradford,  manager  of  this  association,  believes  that  pay- 
ment on  a  butter-fat  basis  has  a  tendency  to  make  farmers 
produce  milk  very  high  in  butter  fat.  The  price  of  butter  fat 
is  fixed  from  time  to  time.  They  also  purchase  by  hundred- 
weight of  milk,  and  give  a  bonus  of  1  cent  per  pound  of  butter 
fat  for  milk  from  tuberculin  tested  herds.  Mr.  Bradford 
thought  the  average  retail  price  for  bottled  milk  in  the  larger 
cities  of  Maine  was  8  cents  per  quart,  while  in  smaller  places 
it  was  as  low  as  6  cents  per  quart.  The  average  price  to  the 
farmer  in  the  State  of  Maine,  he  presumed,  was  3|  to  4|  cents 
per  quart. 

A  farmer  selling  to  the  Turner  Center  Dairying  Association 
stated  that  he  makes  a  profit  of  at  least  $250  per  year  from 
milk  alone  from  10  cows.  Nearly  all  dairymen  interviewed 
were  of  the  opinion  that  they  did  not  lose  any  money  on  their 
milk.  One  criticized  the  method  of  selling,  as  he  was  obliged 
to  take  the  word  of  the  Dairy  Association  as  to  the  weight  and 
fat  contents  of  his  milk. 

All  the  product  of  the  Turner  Center  Dairying  Association 
is  pasteurized.     Pasteurization  is  done  at  creameries  in  Maine. 


66 

The  milk  is  subsequently  bottled  in  Boston  at  the  point  of 
shipment.  Milk  received  at  one  of  the  plants  of  a  Massachu- 
setts contractor  at  Etna,  Me.,  was  not  pasteurized.  It  was 
received  at  the  station,  placed  in  cans  in  ice  water,  and  shipped 
on  the  train  the  following  morning,  arriving  in  Boston  at  4  or 
5  P.M. 

The  committee  visited  the  Province  of  Quebec  to  look,  into 
dairies  shipping  milk  and  cream  into  Massachusetts  by  way 
of  Newport,  Vt.  The  business  of  shipping  milk  at  this  point 
has  gradually  grown  during  the  few  years  it  has  been  in  opera- 
tion until  at  the  present  time  an  average  of  250  40-quart  cans 
or  jugs  of  milk  and  cream  are  sent  out  every  night.  In  addi- 
tion to  this  section  it  was  learned  that  there  were  three  other 
distinct  sections  in  the  Province  of  Quebec  from  which  milk 
and  Cream  were  sent  into  Boston,  viz.,  by  the  Passumpsic 
Division  of  the  Boston  &  Maine  Railroad;  a  triangular  area 
with  apex  at  St.  Albans,  Vt.;  and  a  branch  road  north  of  the 
Grand  Trunk  line,  connecting  with  the  main  line  running  from 
Montreal  to  Portland,  Me.  It  appeared  to  the  committee  that 
the  various  milk  contractors  were  trying  to  keep  the  milk  and 
cream  during  transit  in  as  good  condition  as  when  received. 
Two  methods  of  cooling  were  in  operation  during  transporta- 
tion, —  the  iced  car  and  blanketing.  Inspection  of  one  of  the 
contractor's  creameries  located  at  Newport,  Vt.,  showed  that 
the  conditions  did  not  compare  with  those  existing  in  the  same 
company's  plant  in  Massachusetts.  The  price  paid  at  Newport 
station  for  cream  is  32  cents  per  pound  of  butter  fat,  and  for 
milk,  SI. 60  per  100  pounds  of  milk.  The  prices  are  based  upon 
a  sliding  scale  from  month  to  month.  Twenty-seven  dairies 
were  inspected  in  this  region,  13  of  which  shipped  their  milk 
into  Massachusetts.  The  sanitary  conditions  on  the  various 
farms  compared  very  favorably  with  conditions  found  in  dairies 
located  in  New  Hampshire,  and  were  very  much  better  than 
those  noted  in  the  dairies  visited  in  Vermont.  At  the  time  of 
visit  they  were  being  inspected  by  a  representative  from  the 
United  States  Department  of  Agriculture.  Through  his  efforts 
many  improvements  were  being  made  on  the  different  farms. 
A  good  many  of  the  farmers  in  this  region  are  engaged  in  rais- 
ing young  stock  for  beef,  and  make  use  of  the  skimmed  milk 


67 

for  this  purpose.  One  farmer  stated  that  he  did  not  consider 
there  was  much  money  in  selling  cream,  but  the  skimmed  milk 
disposed  of  in  this  way  helped  out.  The  dairies  in  the  vicinity 
of  Lyndonville,  Vt.,  supplying  the  Lyndonville  Creameries  Asso- 
ciation, were  investigated  in  company  with  the  board  of  health 
of  the  city  of  Newton.  These  dairies  were  found  to  be  in  a 
most  unsanitary  condition,  the  score  for  cleanliness  of  stable 
being  very  low.  In  some  instances  the  separators  were  placed 
directly  behind  the  cows  in  the  open  barn.  It  was  also  a  com- 
mon practice  to  have  privies  in  the  stables.  In  many  instances 
the  milk  was  kept  twenty-four  hours  in  a  tub  of  water  in  the 
stable,  the  covers  of  the  cans  being  generally  partly  removed. 
From  the  foregoing  summary  we  may  conclude  (1)  that  al- 
though the  dairies  in  Massachusetts  as  represented  by  those 
visited,  except  dairies  in  the  Deerfield  valley,  are  reasonably 
satisfactory,  the  conditions  vary  somewhat  in  different  sections, 
and  (2)  that  dairies  in  New  Hampshire,  Vermont,  Maine  and 
the  Province  of  Quebec  do  not  reach  the  same  standards  as 
those  in  Massachusetts.  A  few  deductions  showing  the  differ- 
ences follow :  — 

Dairies  in  Cape  Cod  section,  while  having  barns  that  are  old  and 
methods. and  equipment  not  as  modern  as  are  found  in  other  sections, 
are  nevertheless  well  kept,  neat  and  clean. 

Dairies  about  Lynn  and  Methuen  have  somewhat  better  conditions 
as  to  structure  and  equipment.  In  this  section  are  examples  of  the  best 
conducted  and  equipped  dairies.  One  of  them  requires  regular  inspection 
of  the  cattle  by  veterinaries,  also  medical  inspection  of  the  men  employed. 

Dairies  about  Fitchburg  and  Winchendon  presented  commendable 
conditions.  Dairies  in  Winchendon,  examples  of  the  average  old  farm, 
have  been  brought  up  to  an  excellent  sanitary  condition,  with  good 
separate  milk  rooms,  proper  cooling  facilities  and  equipment  for  the 
sterilization  of  milk  utensils,  etc.,  through  a  local  system  of  educational 
inspection. 

Dairies  in  the  Berkshire  district  are  not  as  well  kept  as  in  other  sections. 
A  number  of  them  engage  in  other  lines,  such  as  raising  pork,  poultry, 
keeping  summer  boarders,  etc.,  so  that  the  dairy  end  failed  to  receive 
the  proper  attention. 

Dairies  in  the  Deerfield  valley  presented  filthy  conditions.  The  farms 
are  run  down  and  are  being  bought  up  by  Polish  people  who  are  gradually 
improving  them.  Only  a  few  cows  are  kept  on  each  of  the  different  farms, 
principally  for  fertilizer,  the  milk  apparently  being  a  by-product. 


68 

Dairies  at  Wethersfield  and  Lyndonville,  Vt.,  presented  the  most 
filthy  conditions  of  any  visited  out  of  Massachusetts.  Drainage  con- 
ditions were  such  as  to  render  the  places  unfit  for  the  housing  of  cattle. 
Facilities  for  the  handling  of  milk  were  entirely  inadequate.  Nasty 
methods  of  cooling  the  milk  were  used. 

Dairies  in  Maine  shipping  to  Massachusetts  contractors  were  in  much 
worse  condition  than  those  supplying  the  local  dairying  association. 
Horse  manure  was  used  in  the  gutters  and  careless  and  nasty  methods 
of  cooling  the  milk  prevailed,  such  as  cooling  in  the  tub  from  which 
cattle  drank. 

Dairies  in  New  Hampshire  have  poor  cow  barns,  lack  of  suitable  milk 
rooms,  crude  methods  of  cooling  the  milk,  and  rather  low  standard  of 
cleanliness. 

Dairies  in  the  Province  of  Quebec  presented  fair  conditions.  Im- 
provements in  some  were  being  made.  They  lacked  suitable  milk  rooms 
and  proper  facilities  for  cooling.  Cows  were  housed  in  the  cellars  of  the 
barns  because  of  the  extreme  cold  in  winter. 

A  summary  of  the  scores  of  the  dairies  inspected  on  these 
trips  is  given  in  the  following  table :  — 


69 


CO 


&Q 


3 


H 

Jj   c3   O 

o 

U5 

CI 

CO 

o 

CO 

Dairies 
near 

DONVILL 
ERMONT. 

o 

rt 

CM 

CO 

•* 

CO 

rt 

„°.i 

o 

CO 

>o 

r- 

00 

t- 

o 

(Sg-3 

o 

CI 

o 

co 

(0 

CQ 

CM 

o 

A 

OP 

H 
03  « 

5  3* 

«  05   H 

S  Si  fi 
2  d  u 
<       CO 

1 

o 

cm 

CM 

CM 

CO 

CO 

1 

' 

2 

P   H   O 

o  g 

CO 

CO 

««o 

1 

t~ 

"5 

1 

1 

"S 

CM 

■* 

CM 

o 

M  E> 

03    O    C 

H  h  ?h 

S  E>  H 

>  go 

<J       CO 

1 

CO 

CM 
CM 

CO 

CO 

>* 

o 

1 

CO 

«  fi  *-" 

<z< 

p§> 

^ga 

1 

o 

US 

CI 

1 

o 

go 

o 

g 

©  s,  2 

*~ 

so 

CO 

CM 

00 

>  go 

<J       CO 

1 

o 

<M 

CO 

■>* 

1 

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CM 

H  H 

!3  £ 

3  "! 

QS 

M°..S 

IO 

to 

■CD 

•o 

o 

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00 

OS 

CO 

o 

o 

cm 

CO 

co      a 

■<      CO 

o 

CO 

CO 

CO 

tH 

f-t 

o 

C5 

o 

rt 

CM 

CO 

■* 

1Q 

CM 

*& 

to 
to 
<u 

■S 

'2 

Wsli 

fc  «C  H  -h 

oQP> 

°2 
qQ 

CO 

CO 

00 
CO 

00 

o 

oo 

1 

o 

§    g 

CI 

CI 

o 

o 

26  of  Childs 

&  Barrows' 
Dairies  in 

New  Hamp- 
shire and 

.  Vermont. 

o 
o 

1 

CI 

CJ 

CO 

CO 

o 

o 

CO 

CO 

^g-3 

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1 

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os 

M3 

U0 

CM 

CO 

CI 

U0 

o 

o 

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03            .    1 

Ji  03  o 
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•o 

CM 

o 

_ 

1  of  Hood 

Dairies, 

Pittsfield 

*Jew  Hami 

SHIRE. 

CM 

■* 

>o 

■* 

1 

1 

OS 

1 

oo 
oo 

OS 

1 

o 

o 
o 

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S3»£ 

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a> 

CO 

«o 

CM 

o 

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1 

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t» 

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l^ 

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o 

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CI 

>* 

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o 

d 

a 

w 

o 

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CO 

M 
03 

tH 

CO 

> 

o 

CI 

CO 

"# 

lO 

CO 

70 


d 

'■+3 

o 
O 


2      « 

5^  Co 


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«3 


&Q 


<§ 


S3  8.  £ 
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o 

a 

a 

^ 

CO 

m     3  eh 

o 

rt 

CM 

CO 

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Dairi 

NEAR 
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BRMON 

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©i 

OO 

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H3 

us 

o 

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00 

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o 
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25 

3  "! 

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26  of  Childs 
&  Barrows' 
Dairies  in 
New  Hamp- 
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Vermont. 

3  p  S 

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o 

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1       1 

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o 

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03             , 

S3  8,2 
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o 

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CM 

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New  H 

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oo 

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71 


14.9 
17.0 
21.0 

32.7 
38.0 

40.8 

47.8 

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14.6 
17.8 
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40.9 

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16-20,    . 
20-24,    . 
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32-36,    . 
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26  of  Child 
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B.  COMPILATION  OF  MILK  CONTRACTORS'  STATEMENTS. 

A  circular  letter  of  inquiry  was  sent  to  the  following  milk 
dealers  doing  business  in  Massachusetts:  — 

Alden  Brothers,  1171  Tremont  Street,  Boston,  Mass. 

C.  Brigham  Company,  158  Massachusetts  Avenue,  Cambridge,  Mass. 
W.  D.  Cowls  &  Son,  North  Amherst,  Mass. 

Deerfoot  Farm,  9  Bosworth  Street,  Boston,  Mass. 

Elm  Farm  Milk  Company,  19  Wales  Place,  Dorchester,  Mass. 

W.  A.  Graustein,  President,  Boston  Condensed  Milk  Company,   134 

Cass  Street  (?),  484  Rutherford  Avenue,  Charlestown. 
H.  P.  Hood  &  Sons,  494  Rutherford  Avenue,  Boston,  Mass. 
Manley  Dairy  Company,  Brockton,  Mass. 
A.  D.  Perry,  Worcester,  Mass. 

Plymouth  Creamery,  268  State  Street,  Boston,  Mass. 
H.  H.  Prentice,  Pittsfield,  Mass. 
J.  B.  Prescott,  Bedford,  Mass. 
Tait  Brothers,  Springfield,  Mass. 
Turner  Center  Company,  63-69  Endicott  Street,  Boston,  Mass. 

D.  Whiting  &  Sons,  590  Rutherford  Avenue,  Boston,  Mass. 

The  letter  requested  information  upon  the  following  points  of 
the  business:  — 

1.  The  quantity  of  milk  and  cream  sold. 

2.  Name  of  Massachusetts  cities  and  towns  in  which  milk  is  sold. 

3.  Approximate  proportion  produced  in  individual  New  England 
States,  New  York  and  Canada. 

4.  Details  as  to  pasteurization. 

5  and  6.  Details  as  to  dealers'  system  of  dairy  inspection. 
7,  8  and  9.  Requests  for  contractors'  opinions  on  certain  aspects  of 
the  milk  business. 

The  answers  to  these  last  three  questions  have  been  discussed 
elsewhere. 

A  few  weeks  after  first  sending  out  the  circular  letter  it  was 
learned  by  accident  that  one  of  the  contractors  had  never  re- 
ceived this  letter,  or  that  it  was  never  referred  to  the  respon- 
sible officer  of  the  firm.  A  second  letter  was  then  sent  by 
registered  mail  to  those  who  had  not  previously  replied.  This 
brought  several  prompt  responses. 

Up  to  November  30  the  following  dealers  have  replied:  — 

1.  Alden  Bros.,  Boston,  Mass. 

2.  C.  Brigham  Company,  Cambridge,  Mass. 

3.  Deerfoot  Farm  Dairy,  Boston,  Mass. 


74 

4.  A.  D.  Perry,  Worcester,  Mass. 

5.  Plymouth  Creamery,  Boston,  Mass. 

6.  H.  H.  Prentice,  Pittsfield,  Mass. 

7.  J.  B.  Prescott,  Bedford,  Mass. 

8.  Tait  Bros.,  Springfield,  Mass. 

9.  Turner  Center  Dairying  Association,  Auburn,  Me. 

10.  D.  Whiting  &  Sons,  Boston,  Mass. 

11.  H.  P.  Hood  &  Sons,  Boston,  Mass. 

No  replies  have  been  received  from  the  following:  — 

1.  W.  D.  Cowls,  North  Amherst,  Mass. 

2.  Elm  Farm  Milk  Company,  Boston,  Mass. 

3.  W.   A.   Graustein,   President,   Boston  Condensed   Milk   Company, 

Charlestown,  Mass. 

4.  Manley  Dairy  Company,  Brockton,  Mass. 

The  following  is  a  summary  of  the  replies  received:  — 

Question  1 .  —  Approximately  how  much  milk  and  cream  per  annum 
do  you  sell?    Wholesale?    Retail? 

For  trade  reasons  most  of  the  dealers  declined  to  state  ex- 
actly how  much  milk  or  cream  they  now  handle.  Two  or  three 
of  the  smaller  dealers  and  two  large  contractors  gave  exact 
figures. 

The  Boston  contractors  report  that  their  product  is  sold  in 
Arlington,  Belmont,  Boston,  Brookline,  Brockton,  Cambridge, 
Chelsea,  Cohasset,  Everett,  Hull,  Maiden,  Marlborough,  Med- 
ford,  Melrose,  Newton,  Quincy,  Revere,  Somerville,  Southbor- 
ough,  Stoneham,  Winchester,  Winthrop,  Woburn  and  Worcester. 

Cream  is  also  distributed  in  addition  to  the  above  localities 
in  the  following  places:  Abington,  Attleboro,  Amesbury,  Barn- 
stable, Fall  River,  Foxborough,  Gloucester,  Hanover,  New  Bed- 
ford, Provincetown,  Maynard  and  Wareham. 

Tait  Bros,  of  Springfield  report  that  their  output  is  sold  in 
Springfield,  West  Springfield,  Holyoke,  Chicopee  and  Fitchburg. 

Question  8.  —  Approximately  what  proportion  of  your  milk  and  cream 
sold  in  Massachusetts  is  produced  in  — 
(a)  Massachusetts? 
(6)  New  Hampshire  and  Vermont? 

(c)  Maine? 

(d)  Connecticut? 

(e)  New  York? 
(J)  Canada? 


75 

This  question  was  asked  in  order  to  ascertain  the  amount  of 
milk  obtained  in  the  different  States  and  the  Dominion  of 
Canada,  and  particularly  the  proportion  produced  outside  of 
Massachusetts.  Owing  to  the  absence  of  answers  to  question 
1,  the  replies  to  question  3  cannot  be  used  for  this  purpose,  as 
they  are  expressed  in  percentage. 

None  of  the  cream  sold  by  the  large  dealers  doing  business 
in  greater  Boston  is  produced  in  Massachusetts.  Most  of  this 
cream  comes  from  Vermont  and  Maine,  and  a  small  supply 
from  Canada.  Our  own  investigations,  however,  show  that  one 
contractor  obtains  a  large  amount  of  cream  from  Canada. 
These  statements,  are  therefore  by  no  means  conclusive. 

Question  J+-  —  How  much  of  your  milk  and  cream  is  pasteurized? 
Where  is  it  pasteurized?    Type  of  pasteurizer? 

Maximum  temperature  of  which  milk  or  cream  is  heated?  Time 
held?    Temperature  of  holding? 

Is  any  of  your  milk  or  cream  re-pasteurized?  If  so,  state  location  and 
character  of  the  first  and  final  pasteurizing  plant. 

All  the  large  dealers  practice  pasteurization  except  in  the 
case  of  the  small  amounts  of  certified  milk  sold  and  of  milk 
sold  to  milk  peddlers.  In  general,  the  milk  is  pasteurized  but' 
once,  at  the  headquarters  of  the  principal  receiving  stations  of 
the  corporations.  The  holding  process  is  used,  the  milk  being 
held  for  thirty  minutes  at  a  temperature  of  143°  to  145°  F. 
Some  of  the  family  cream  is  repasteurized.  In  general,  a  higher 
temperature  is  used  in  pasteurizing  cream,  the  dealers  stating 
temperatures  as  high  as  165°  F. 

Questions  5  and  6.  —  Do  you  maintain  a  system  of  dairy  inspection? 
If  so,  describe  the  principal  features  of  your  system  of  dairy  inspection. 

To  question  5,  7  answered  yes  and  4  answered  no.  The 
typical  system  is  to  have  the  agents  of  the  receiving  stations 
inspect  each  dairy  three  or  four  times  a  year,  score  the  same 
and  urge  the  dairymen  to  correct  insanitary  conditions.  No 
statement  is  made,  however,  as  to  whether  or  not  dairies  found 
dirty  are  excluded. 

One  of  the  largest  dealers  replying  no  to  question  5,  in  his 
reply  to  question  6  showed  he  maintained  an  inspection  system 
similar  to  the  others,  except  that  he  did  not  score  the  dairies. 


76 

Several  of  the  large  firms  have  inaugurated  features  of  in- 
spection which  deserve  special  commendation;  for  example,  one 
dealer  states  they  retain  a  chief  inspector  who  is  a  thoroughly 
experienced  dairyman,  a  graduate  of  the  New  Hampshire  State 
Agricultural  College,  and  supplement  their  inspection  by  illus- 
trated lectures  for  the  benefit  of  the  producers  on  the  sani- 
tary and  economic  aspects  of  milk  production. 

Another  company  retains  a  veterinary  inspector  for  the  ex- 
amination of  the  cattle  and  stables,  and  a  bacteriologist  of  na- 
tional reputation  to  supervise  the  bacteriological  examinations. 

Another  dealer  states  that  his  inspector  scores  the  farms  using 
the  United  States  dairy  score  card,  and  he  also  employs  the 
honor  system  of  inspection.  The  producer  scores  his  own  farm, 
answering  monthly  a  list  of  four  questions  by  yes  or  no.  These 
questions  are  relative  to  cooling  the  milk  below  50°  F.,  having 
and  using  a  milk  house,  whitewashing  the  stable,  and  the  win- 
dow and  air  space  per  cow.  A  cash  premium  is  paid  if  these 
questions  are  answered  in  the  affirmative. 

Another  dealer  appears  to  get  into  the  closest  co-operation 
with  the  local  boards  of  health.  He  very  logically  leaves  it  to 
the  board  of  health  to  first  score  and  issue  a  permit  to  the 
dairy  before  the  milk  is  purchased.  Thereafter  they  utilize 
their  own  inspector  to  see  if  the  dairies  keep  up  the  original 
standard  set.  Whenever  they  find  a  decline  in  these  standards 
the  board  of  health  is  at  once  notified,  thereby  placing  the 
responsibility  for  refusing  the  milk  on  the  local  board  of 
health,  as  it  should  be. 

One  corporation  makes  a  practice  of  having  the  creamery 
managers  accompany  the  inspectors  of  the  Health  Department 
on  their  visits  to  the  dairies,  and  your  Board  is  satisfied  from 
personal  observation  that  they  rigidly  refuse  to  accept  the  prod- 
uct of  any  dairy,  the  score  of  which  is  below  the  requirements 
of  the  health  authorities,  until  these  dairies  have  complied  with 
the  recommendations  of  the  inspector. 

At  the  central  plant  of  this  corporation  occasional  examina- 
tions are  made  for  bacteria  and  for  sediment.  If  the  milk  ex- 
hibits any  sediment,  or  if  the  bacterial  content  is  found  to  be 
high,  the  producer  is  notified  of  this  fact,  and  the  subsequent 
shipments  of  milk  are  carefully  watched  to  ascertain  whether 


77 

or  not  the  producer  has  'complied  with  the  suggestions  made 
by  the  company. 

One  contractor,  evidently  missing  the  point  of  the  question, 
rather  ingenuously  replied,  "  Yes,  by  our  city  inspector  and 
also  by  the  State  Board  of  Health."  Another  contractor 
answered  rather  modestly,  "No,"  but  in  all  probability  main- 
tained a  system  quite  as  efficient  as  his  larger  competitors. 
He  states,  "Not  a  regular  system,  but  I  visit  them  if  the  milk 
don't  suit." 

Somewhat  as  an  offset  to  the  very  encouraging  and  broad- 
minded  policies  which  these  contractors  maintain  and  have 
instituted  for  the  purpose  of  bettering  the  sanitary  quality  of 
their  product,  strict  impartiality  requires  us  to  state  that  one 
of  the  dealers,  who  now  states  that  he  does  not  repasteurize 
at  all,  admitted  under  oath  a  few  years  ago  that  a  portion  of 
his  product  was  occasionally  submitted  to  a  second  pasteuri- 
zation. 

The  reports  of  the  special  investigations  made  by  your  Board 
seem  to  indicate  that  the  system  of  inspection  operated  by  the 
contractor  is  not  as  efficient  in  certain  localities  as  the  con- 
tractor's replies  would  indicate.  In  fact,  we  are  forced  to  con- 
clude that  the  policy  of  using  the  local  collecting  agent  as  a 
dairy  inspector  frequently  results  in  giving  the  dealers  them- 
selves an  altogether  erroneous  impression  of  the  sanitary  con- 
ditions pertaining  to  the  dairies  from  which  they  obtain  their 
milk. 

C.  OBSERVATIONS  ON  PAST  AND  PRESENT  INCREASE,  DE- 
CREASE, FLUCTUATIONS  AND  GEOGRAPHICAL  MOVE- 
MENTS OF  COMMERCIAL  MILK  AND  CREAM  PRODUC- 
TION IN  MASSACHUSETTS  AND  NEIGHBORING  STATES 
AND  THE  PROVINCE  OF  QUEBEC  IN  RELATION  TO  THE 
MILK  SUPPLY  OF  THIS  COMMONWEALTH. 

A  study  of  the  production  of  milk  in  Massachusetts  reveals 
the  fact  that  while  there  has  been  a  constant  increase  in  popu- 
lation in  this  State  since  1885,  at  which  time  the  statistics 
quoted  begin,  there  has  been,  at  the  same  time,  a  decrease  in 
the  number  of  milch  cows  kept  in  this  State.  From  1885  to 
1890  there  was  a  great  increase  in  the  number  of  milch  cows. 
According  to  statistics  the  increase  was  at  the  rate  of   about 


78 

6,400  per  year,  and  in  1890  the  highest  point  was  reached  in 
the  number  of  cattle,  which  was  200,658.  From  1890  down 
to  1914  there  has  been  a  great,  although  not  a  uniform,  de- 
crease, but  in  the  five  years  from  1890  to  1895  the  decrease 
was  almost  as  great  as  the  increase  had  been  in  the  previous 
five  years.  From  1895  to  1897  there  was  a  decrease,  although 
not  as  rapidly  as  in  the  previous  five  years.  From  1897  to 
1899  there  was  an  increase  in  the  number  of  cows  kept,  which 
in  1899  reached  a  total  of  a  little  more  than  180,000.  The 
number  remained  approximately  stationary  until  1906,  and 
from  1906  to  the  present  time  there  has  been  a  rapid  decrease 
at  an  average  rate  of  4,000  cows  per  year.  From  1890,  when 
the  greatest  number  of  milch  cows  kept  in  this  State  was 
reached,  until  1914  there  has  been  an  average  decrease  in  the 
number  of  cows  of  a  little  over  2,200  per  year,  so  that  while 
there  was  a  production  of  milk  at  the  rate  of  one-half  quart 
per  person  in  Massachusetts  in  1890,  in  1914  there  was  pro- 
duced one-fifth  quart  per  person  in  population. 

Although  the  amount  of  milk  used  per  person  has  increased 
according  to  different  authorities,  for  the  sake  of  comparison 
we  will  assume  it  to  be  the  same. 

Diagrams  showing  the  comparative  number  of  milch  cows 
and  the  population  of  the  State  of  Massachusetts,  also  show- 
ing the  amount  of  milk  brought  into  the  city  of  Boston  by 
the  steam  railroads  for  the  years  1896  to  1914,  are  included 
in  this  report.  The  amount  of  milk  and  cream  is  given  in  mil- 
lions of  quarts,  and  there  was  a  decided  decrease  from  1906 
to  1911  in  the  amount  handled  on  trains.  From  1911  to  1913 
there  was  almost  as  great  an  increase  in  the  total  amount 
handled  on  the  railroads  as  there  had  been  a  decrease  in  1906 
to  1911. 

Another  interesting  diagram  shows  the  relative  amount  of  milk 
handled  by  the  three  large  railway  systems  coming  to  Boston. 
One  curve  shows  the  amount  of  milk  handled  by  the  Boston  & 
Maine.  There  was  a  decrease  from  1906  to  1910.  From  1910 
to  1911  the  amount  remained  about  the  same,  but  from  1911 
to  1913  there  was  a  very  rapid  increase  in  the  amount  handled 
by  this  railroad,  which  increase  corresponds  to  the  rapid  in- 
crease in  the  total  amount  of  milk  brought  into  Boston. 


79 


On  the  New  York,  New  Haven  &  Hartford  Railroad  there 
was  an  increase  in  the  amount  brought  into  Boston  from  the 


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year  1906  to  the  year  1910,  a  decrease  in  1912,  and  the  amount 
remained  about  constant  from  1912  to  1914. 

In  the  case  of  the  Boston  &  Albany  there  has  been  a  steady 
decrease  from  the  year  1906  to  the  year  1914.    The  increase  in 


80 

the  amount  of  milk  brought  into  Boston  by  the  Boston  & 
Maine  Railroad  from  1911  to  1913  corresponds  with  the  in- 
crease in  the  total  amount  of  milk  brought  into  Boston  for 
those  years.  In  1913  to  1914  there  is  a  decrease  shown  in  the 
amount  which  also  corresponds  to  the  decrease  in  the  total 
amount.  The  increase  in  the  amount  brought  into  Boston  by 
the  Boston  &  Maine  not  only  corresponds  to  the  increase  in 
the  total  amount  brought  into  Boston,  but  it  also  corresponds 
with  the  amount  of  milk  brought  into  Massachusetts  from  the 
Province  of  Quebec  by  different  Boston  contractors. 

It  would  seem  from  the  diagram  that  the  milk  contractors 
have  been  going  farther  from  Massachusetts,  as  time  goes  on, 
to  get  the  milk  and  cream  with  which  they  are  supplying  the 
people  of  this  State. 

A  feature  of  the  diagram  is  the  notable  decrease  in  the  total 
amount  of  milk  and  cream  coming  into  Boston  in  the  years 
1913  and  1914,  whereas  the  increase  in  the  population  of  Bos- 
ton, or  the  metropolitan  district,  which  probably  receives  most 
of  the  milk  and  cream  which  is  brought  into  Boston  by  the 
railroads,  has  been  at  about  the  same  rate  as  in  previous  years. 
This  discrepancy  has  been  studied  with  a  view  to  finding  out 
whether  there  has  been  a  per  capita  decrease  in  the  amount  of 
milk  and  cream  used  as  stated  by  several  parties,  but  it  has 
not  been  found  that  this  is  so.  Neither  has  it  been  determined 
that  people  are  using  more  milk  and  cream  per  capita  than 
formerly,  as  has  also  been  stated,  but  the  amount  probably 
remains  about  the  same.  A  part  of  the  decrease  can  be  ac- 
counted for  by  the  statements  of  some  of  the  milk  contractors 
that  the  surplus  which  formerly  was  shipped  into  Boston  and 
manufactured  into  butter  and  other  products  at  the  Boston 
milk  stations  is  now  largely  cared  for  out  in  the  country,  thus 
relieving  the  factories  of  some  of  the  work,  and  resulting  in  a 
saving  in  railroad  transportation.  Probably  the  increased  use 
of  condensed,  evaporated  and  powdered  milk  accounts  for  some 
of  the  decrease  in  the  amount  brought  in  by  the  railroads,  as 
shown  by  the  figures  obtained  from  the  Chamber  of  Commerce 
and  agents  of  two  of  the  large  condensing  and  evaporating 
firms. 

A  study  has  been  made  to  find  out  to  what  extent  condensed, 
evaporated  and  powdered  milk  has  taken  the  place  of  fluid  milk 


81 


in  manufacturing  and  in  the  homes,  and  these  results  are  in- 
cluded with  this  report. 

It  seems. to  have  been  the  general  opinion  of  investigators  of 
the  past  that  the  facts  of  milk  production,  especially  from  the 


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cost  standpoint,  should  receive  a  great  deal  of  attention,  and, 
in  fact,  there  has  been  a  great  deal  of  time,  with  attendant 
expense,  devoted  to  this  side  of  the  question  in  milk  produc- 
tion. There  must  have  been  good  reasons  for  the  study  of  the 
production  costs  when  the  question  was  a  new  one,  but  it  seems 


82 

unnecessary  to  continue  such  work  to  any  great  extent,  in  view 
of  the  fact  that  all  sides  of  the  question  have  been  thoroughly 
considered  and  the  results  have  invariably  been  the  same,  and 
so  far  as  can  be  ascertained  no  dispute  as  to  the  statements  of 
cost  has  been  made.  Taking  into  consideration  the  fact  that 
only  a  small  percentage  of  the  milk  producers  have  kept  item- 
ized accounts  that  would  enable  them  to  accurately  determine 
the  cost  of  producing  a  quart  of  milk,  and  also  the  fact  that 
conditions  vary  so  on  different  farms  even  in  the  same  locality, 
the  question  is  raised  as  to  the  value  of  any  one  set  of  figures 
being  greater  than  another.  That  the  figures  given  by  different 
producers  who  have  testified  at  different  investigations,  and 
who  have  given  this  Board  figures  on  the  cost  of  producing,  do 
not  agree  is  no  reason  for  condemning  such  figures,  as  the  con- 
ditions vary  so  much  on  the  different  farms  on  account  of  the 
varied  lines  of  agriculture  carried  on  at  these  places  that  they 
may  be  just  as  accurate  and  reliable  in  one  case  as  in  another, 
and  it  would  seem  to  be  impossible  to  fix  any  exact  price  for 
which  milk  could  be  produced  as  long  as  it  is  produced  under 
the  many  different  conditions  as  at  present.  But  as  the  cost 
estimates  vary  so  slightly,  that  is,  generally  within  less  than 
a  cent  per  quart,  it  would  seem  as  though  an  approximate  idea 
can  be  obtained  of  the  cost  in  the  different  zones. 

In  some  cases  milch  cows  are  kept  as  the  sole  source  of  in- 
come, and  one  will  naturally  think  that  in  that  case  the  lowest 
cost  of  production  would  be  reached,  but  such  is  not  always 
the  fact,  as  in  some  of  the  cases  the  highest  cost  of  production 
is  reached.  It  is  difficult  to  form  an  opinion  as  to  the  exact 
cost  of  production  on  those  farms  where  the  dairy  business  is 
run  simply  as  a  side  line,  as  a  part  of  the  profits  on  these  places 
is  the  fertilizer  that  is  used  in  producing  the  vegetables  or 
fruit,  and  it  has  been  said  that  the  value  of  the  fertilizer  varies 
with  the  'value  of  the  crop  raised,  so  that  some  people  have 
maintained  that  it  was  difficult  to  estimate  the  value  of  a  cord 
of  manure,  as  in  some  soils  the  value  will  be  much  greater  than 
others.  Stable  manures  have  a  much  greater  value  than  a  com- 
mercial fertilizer  containing  the  same  amount  of  nutritive  ele- 
ments when  used  in  a  soil  that  needs  the  addition  of  humus. 

It  must  be  a  fact  that  the  cost  of  producing  a  quart  of 
milk  has  increased  in  the  last  few  years,  as  all  of  the  material 


83 

used  in  the  construction  of  buildings  and  the  feeding  of  cattle 
has  decidedly  increased.  The  price  of  cows  has  greatly  in- 
creased, and  also  the  price  of  all  farm  labor.  It  has  been 
stated  by  some  of  the  milk  producers  with  whom  we  have  cor- 
responded that  the  cost  of  producing  a  quart  of  milk  has  in- 
creased 15  per  cent,  in  the  last  few  years,  and  it  is  safe  to  say 
that  the  increased  cost  of  producing  a  quart  of  milk  is  greater 
near  the  large  centers  of  population  than  in  the  more  remote 
districts,  owing  to  the  fact  that  labor  costs  generally  more,  and 
that  taxes  on  farm  lands  have  been  increased  more  in  propor- 
tion than  they  have  in  the  outlying  districts. 

'The  element  of  pastures  enters  largely  into  the  cost  of  the 
production  of  milk,  because  milk  can  be  produced  more  cheaply 
in  the  sections  where  the  pastures  are  good  than  in  the  sections 
where  the  pastures  are  poor.  The  dairying  sections  of  the 
states  of  Vermont  and  New  Hampshire  can  produce  milk  more 
cheaply  for  this  reason  than  many  sections  of  Massachusetts, 
and  in  proportion  milk  can  be  produced  more  cheaply  in  the 
Province  of  Quebec  than  in  the  portions  of  Vermont  and  New 
Hampshire  mentioned.  This  is  due  to  the  fact  that  the  farther 
north  one  goes  from  the  city  of  Boston  to  the  St.  Lawrence 
River  in  Canada  the  heavier  soils  produce  more  and  better 
pastures  than  the  sandy  soil  in  the  eastern  part  of  Massa- 
chusetts, and  also  to  the  fact  that  good  pasture  lands  are 
much  cheaper  in  Canada  than  in  the  New  England  States. 

It  is  a  mistake  to  say  that  because  farmers  do  not  keep  an 
accurate  set  of  books  they  do  not  know  whether  there  is  a 
profit  or  loss  in  the  production  of  milk.  In  interviewing  a  large 
number  it  has  been  found  that  those  who  have  been  milk 
producers  for  more  than  four  or  five  years  have  a  very  good 
idea  of  the  cost  of  milk  production  which  experience  has  given 
them.  Almost  any  farmer  of  a  few  years'  experience  knows 
how  much  hay  or  other  forage  his  place  produces;  knows  in  a 
general  way  how  much  money  he  is  spending  every  month  for 
grain;  can  easily  tell  whether  his  farm  has  increased  in  pro- 
duction; and,  if  he  is  dependent  entirely  on  the  dairy  business, 
most  certainly  knows  whether  he  has  more  money  or  less  than 
formerly. 

To  give  an  idea  of  the  importance  of  the  dairy  industry  in 
the  United  States,   statistics  from  the   United  States  Census 


84 

reports  are  used  as  being  the  only  ones  available  and  with  the 
belief  that  these  figures  are  approximately  correct;  but  it 
must  be  understood  that  these  figures  do  not  show  anything 
as  to  the  great  importance  of  dairying  in  its  connection  with 
other  lines  of  agriculture,  which  may  well  be  said  to  rely  upon 
the  keeping  of  cattle  for  their  perpetuation,  and  it  is  probable 
that  many  agricultural  products  would  greatly  advance  in 
price  owing  to  the  difficulty  of  producing  them  without  the 
animal  fertilizers  produced  in  dairying.  It  has  been  stated  by 
competent  judges  of  agricultural  work  that  the  only  way  in 
which  milk  production  can  be  carried  on  successfully  in  New 
England  is  in  combination  with  other  lines  of  agriculture,  and 
in  the  future  we  must  depend  upon  the  farmer  who  produces 
milk  as. one  line  of  his  diversified  farming  rather  than  on  the 
men  who  will  keep  large  herds  of  milch  cows  and  follow  milk 
production  as  an  exclusive  line. 

Milk  production  by  small  farmers  as  a  side  line  would 
probably  be  much  better  for  the  consumer  from  a  cost  point  of 
view,  as  it  is  extremely  doubtful  if  a  combination  to  raise  or 
fix  prices  could  ever  be  effected,  and  in  connection  with  this 
statement  it  might  be  well  to  call  attention  to  the  statements 
of  interested  persons  who  have  said  that  if  it  had  been  the 
custom  of  New  England  milk  producers  to  conduct  the  business 
as  an  exclusive  line  rather  than  a  side  line  the  public  long  ago 
would  have  been  compelled  to  pay  a  much  larger  price  for 
dairy  products.  It  is  only  because  the  other  lines  have  been 
more  profitable  than  dairying  that  the  farmers  have  been  able 
to  produce  milk  and  sell  it  at  less  than  the  actual  cost. 

Uses  of  Milk. 
Cow's  milk  and  its  manufactured  products  have  many  uses, 
and  there  will  always  be  a  demand  for  this  important  article. 
Probably  the  most  important  use  to  which  milk  is  put  is  the 
feeding  of  infants,  and  it  seems  improbable  that  we  could  ever 
find  a  substitute  for  milk  for  this  purpose  that  would  be  as 
satisfactory  or  as  efficient.'  Milk  occupies  an  important  place 
in  the  daily  diet  of  many  people  who  either  have  to  use  it  as  a 
portion  of  their  food,  or  in  some  cases  as  their  entire  food  on 
account  of  physical  disorders,  or  who  find  it  an  agreeable  and 


85 


nutritious  article  of  diet  to  be  used  daily  in  conjunction  with 
the  more  solid  foods. 

The  use  of  cream  has  increased  very  fast  in  the  last  twenty 
years,  and  is  considered  by  many  as  an  indispensable  article 


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in  the  daily  menu.  The  ice-cream  business  has  assumed  vast 
proportions,  and  the  use  of  cream  in  the  manufacture  of  ice 
cream  is  an  important  factor.  Milk  is  used  more  extensively 
than  ever  before  for  cooking  purposes,  and  bakers  nowadays 


86 


make  more  products  containing  milk  than  formerly.  Butter  is 
too  well  known  a  commodity  to  require  any  comment,  but 
attention  should  be  drawn  to  the  fact  that  buttermilk  has  a 
considerable  market  value  at  the  present  time,  and  its  use  as 


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a  beverage  has  become  quite  a  factor  in  disposing  of  the 
by-product  of  butter-making  which  formerly  had  little  value. 
Cheese  is  a  highly  important  product  of  the  dairy  industry,  and 
its  -use  is  said  to  be  increasing.     The  amount  of  butter  and 


87 

cheese  produced  in  Massachusetts  is  very  small,  and  is  generally 
produced  for  home  use  only. 

By-products  of  milk  are  used  in  the  manufacture  of  different 
articles  to  an  extent  that  is  almost  incomprehensible  to  the 
uninformed.  In  considering  the  many  ways  in  which  milk  is 
used,  it  is  well  to  follow  it  from  its  point  of  production  through 
the  many  hands  and  operations  before  it  reaches  the  consumer. 
In  New  England,  as  a  general  thing,  the  whole  milk  is  sold  by 
the  producers  to  large  dealers  who  run  cars  out  into  the  pro- 
ducing districts,  and  who  either  receive  it  at  the  car  or  at  the 
local  receiving  station,  where  it  may  be  separated  and  the 
cream  shipped  to  the  large  centers  and  the  skimmed  milk  used 
in  various  ways,  or  the  whole  milk  may  be  shipped  without 
any  treatment  except  icing  in  a  more  or  less  efficient  way.  The 
whole  milk  or  the  cream  may  or  may  not  be  pasteurized  at  the 
receiving  station  or  country  creamery.  The  country  shipping 
point  may  be  300  or  more  miles  away  from  the  main  plant. 
If  the  receiving  station  is  a  creamery  where  butter  is  manufac- 
tured, the  farmers  generally  bring  in  the  whole  milk,  although 
in  some  cases  they  have  separators  and  carry  in  only  the  cream. 
The  farmers  who  bring  in  whole  milk  buy  back  the  skimmed 
milk.  The  skimmed  milk  is  used  for  feeding  calves,  hogs  and 
poultry.  It  has  been  said  that  in  former  years  some  creameries 
followed  the  custom  of  either  giving  the  skimmed  milk  away  or 
throwing  it  on  to  the  ground  or  into  streams  where  it  would 
flow  away.  In  some  parts  of  the  country  serious  stream  pollu- 
tion has  been  reported  in  many  cases  where  the  latter  method 
has  been  adopted,  but  it  may  be  that  the  pollution  was  more 
the  result  of  materials  used  in  washing  utensils  and  floors  than 
of  the  skimmed  milk.  Of  late  years,  where  there  has  been  a 
large  amount  of  skimmed  milk  at  the  milk  stations,  it  has  be- 
come the  custom  to  reduce  the  skimmed'  milk  to  milk  powder 
for  bakers'  use,  or  for  use  in  some  instances  in  making  a  so- 
called  synthetic  milk  by  the  addition  of  fat  and  water  in  proper 
proportions.  In  some  instances  it  is  made  into  a  high  protein 
feed  for  poultry,  and  to  some  extent  is  used  in  the  manu- 
facture of  cold-water  paint.  Quite  a  considerable  quantity  of 
skimmed  milk  is  condensed  for  use  on  board  ships,  etc.  When 
skimmed  milk  is  spoiled  by  age  or  in  some  other  way,  or  where 


88 

there  is  no  other  method  of  disposing  of  it,  the  most  common 
procedure  is  to  manufacture  casein. 

Casein  is  used  very  extensively  in  the  paper  industry,  making 
possible  the  manufacture  of  washable  wall  papers,  also  in  the 
waterproofing  of  paper  flasks,  cartons  and  wrapping  papers. 
It  is  used  for  coating  paper  slates  and  drawing  papers,  and  as 
a  fixing  agent  for  enamels  and  colors  on  papers.  Casein  paints 
are  quite  extensively  used,  and  the  plasters  which  can  be  made 
by  the  combination  of  casein  with  other  substances  are  useful 
in  the  decorator's  art  and  for  making  molds.  Insulators  for  elec- 
trical appliances  and  transparent  sheets  resembling  celluloid  and 
mica  are  manufactured  from  casein  compounds,  and  in  the  dye- 
ing and  printing  of  textile  fabrics  it  is  also  very  useful.  Casein 
is  used  in  large  quantities  in  the  manufacture  of  linoleums, 
and,  to  some  extent,  in  the  compounding  of  medicines  and 
foods. 

When  we  consider  how  important  milk  has  become  as  an 
article  of  food  and  in  the  arts  and  sciences,  and  how  useful  even 
the  poorer  parts  and  cheaper  grades  can  be,  it  would  seem  as 
though  the  encouragement  of  the  production  of  milk  must 
surely  tend  to  increase  the  general  prosperity  of  the  entire 
country.  When  we  consider  the  enormous  amount  of  money 
involved  in  the  dairy  industry  of  the  United  States,  and  the 
important  uses  to  which  dairy  products  are  adapted,  we  are 
justified  in  pausing  for  a  while  before  declaring  that  certain 
laws  and  regulations  would  be  either  beneficial  or  detrimental 
to  this  great  industry. 

Many  reasons  have  been  assigned  or  suggested  as  having 
had  a  direct  influence  on  the  decrease  in  the  amount  of  milk 
produced  in  the  State  of  Massachusetts.  These  are  quoted  not 
as  matters  of  fact,  but  simply  to  record  some  of  the  ideas  as 
expressed  by  various  persons.  Several  persons  have  suggested 
that  the  past  work  of  the  State  Board  of  Health  has  had  a 
decided  influence  by  reason  of  the  methods  employed  iD  prose- 
cuting farmers  and  others  for  offences  against  the  law.1 

Another  reason  for  the  decrease  in  production  is  said  to  be 

1  The  critics  did  not  take  into  account  the  fact  that  the  State  Board  of  Health  had  for  years 
practiced  the  warning  system  with  no  advantage,  and  the  new  secretary  furnished  the  inspectors 
a  long  list  of  the  people  who  had  been  warned.  The  samples  collected  resulted  in  a  large  number 
of  prosecutions.  —  H.  C.  L. 


89 

the  result  of  milk-borne  epidemics  being  sensationally  featured 
by  the  newspapers.  This  publicity  is  said  to  have  resulted  in 
a  decrease  in  the  amount  of  milk  consumed  for  at  least  a  time. 
Many  producers  have  stated  that  a  large  part  of  the  decrease 
has  been  due  to  the  feeling  of  unrest  and  insecurity  on  the 
part  of  the  farmers,  occasioned  by  the  constant  agitation,  legis- 
lative and  otherwise,  that  they  have  been  subjected  to  for  the 
past  several  years,  and  some  have  said  that  improvements  have 
been  delayed  in  many  cases  because  dairymen  were  afraid  that 
it  would  not  pay  them  to  stay  in  the  business  if  drastic  laws 
were  to  be  passed. 

Another  reason  is  said  to  be  the  constantly  increasing  use  of 
condensed  and  evaporated  milk  by  families  and  the  increase  in 
the  amount  of  milk  powders  used  by  bakers.  Probably  the 
increased  use  of  milk  powders  and  of  condensed  and  evaporated 
milk  is  responsible  for  some  of  the  decrease  in  the  amount  of 
milk  brought  into  Boston  by  the  different  railroads  in  the  year 
1913,  and  also  for  the  general  decrease  of  about  10,000,000 
gallons  in  the  yearly  amount  between  the  years  1906  and  1914. 

How  much  bearing  the  financial  panics  and  bad  business 
conditions  of  different  periods  may  have  had  on  the  amount 
of  milk  produced  and  the  amount  consumed  is  problematical, 
but  we  may  well  assume  that  such  conditions  have  had  their 
influence. 

A  large  number  of  dairymen  have  given  the  low  price  paid  to 
the  producer  as  the  principal  and  almost  only  reason  for  the 
great  decrease  in  production  in  this  State.  This  seems  to  be 
the  most  reasonable  one,  because  many  of  the  producers  have 
said  that  the  price  received  for  milk  during  the  last  few  years 
has  not  been  sufficient  to  enable  them  to  make  a  profit,  and 
that  in  many  cases  the  price  paid  was  below  the  cost  of  pro- 
duction. 

It  has  been  stated  by  many  dairymen  that  the  production 
per  cow  in  Massachusetts  has  increased  from  10  to  15  per  cent, 
in  the  last  fifteen  years,  this  increase  having  been  secured  by 
more  careful  selection  of  cattle,  breeding  for  production,  and 
because  of  a  better  knowledge  of  the  problems  of  feeding. 
Some  have  claimed  that  the  greater  production  of  the  Mas- 
sachusetts   herds    over    those   of    other    States   and    countries 


90 

should  have  helped  the  dairymen  in  overcoming  the  difference 
of  cost  in  production  between  this  State  and  States  farther 
north,  where  the  pasture  conditions  are  better  than  they 
generally  are  in  Massachusetts. 

Criticisms  have  been  made  of  the  result  of  the  Saunders  law, 
which  at  one  time  was  believed  would  help  Massachusetts 
producers,  but  many  have  expressed  the  opinion  that  it  has 
really  resulted  in  hurting  the  Massachusetts  industry. 

Another  reason  assigned  as  the  cause  of  decrease  in  pro- 
duction in  the  State  of  Massachusetts  is  the  growing  interest 
taken  in  fruit,  vegetable  and  poultry  raising  by  farmers  who 
were  formerly  engaged  in  dairying. 

Scarcity  of  labor  at  reasonable  prices  has  also  been  given  as 
one  of  the  reasons  for  the  decline,  and  some  farmers  claim  to 
have  been  discouraged  by  the  fact  that  the  only  laborer  avail- 
able at  any  price  in  some  districts  is  the  foreign-born  laborer, 
who  does  not  understand  the  English  language,  and  who 
understands  but  little  of  farming  conditions  and  work  in  this 
country;  and  it  is  a  fact  that  new  arrivals  on  these  shores 
demand,  in  many  cases,  $30  to  $35  per  month  and  board,  and 
generally  obtain  these  prices  on  account  of  the  scarcity  of 
laborers. 

An  interesting  feature  of  the  business  of  milk  production  in 
Massachusetts  at  the  present  time  is  the  work  being  done  by 
the  State  Board  of  Agriculture,  through  its  Dairy  Bureau, 
along  the  lines  of  the  encouragement  of  a  greater  production  of 
milk  of  a  high  quality.  For  the  purpose  of  interesting  Massa- 
chusetts dairymen  the  Legislature  has  appropriated  money  to 
the  State  Board  of  Agriculture,  and  they  have  conducted  for 
the  last  three  years  a  series  of  clean  milk  contests,  which  has 
resulted  in  the  production  of  high-class  milk  on  places  which 
formerly  had  been  somewhat  indifferent  to  some  of  the  neces- 
sary details  of  clean  milk  production. 

The  Milk  Board  in  conducting  its  dairy  investigations  has 
visited  several  places  that  have  been  entered  in  these  clean 
milk  contests,  some  of  which  have  won  prizes.  The  winning  of 
a  prize  in  these  contests  has  meant  a  great  deal  to  the  winners, 
as  it  has  resulted,  in  some  instances,  in  their  getting  a  better 
price  for  milk  when  they  distributed  their  milk  direct  to  the 
consumer. 


91 

There  are  some  good  figures  available  on  cost  of  production 
of  milk  in  Massachusetts,  probably  none  of  them  better  than 
those  of  Elmer  D.  Howe  of  Marlborough,  a  practical  dairyman, 
who  is  a  graduate  and  trustee  of  the  Massachusetts  Agricultural 
College,  and  also  a  past  master  of  the  Massachusetts  State 
Grange.  The  figures  are  based  on  his  own  herd  of  40  cows. 
Mr.  Howe  says :  — 

Our  experiment  stations  agree  that  the  average  cow  in  milk  needs, 
for  economical  production,  25  pounds  of  hay  or  its  equivalent  in  silage, 
roots,  etc.,  plus  8  pounds  of  grain.  This  will  make  the  food  cost  per  day 
(with  hay  at  $20  per  ton  and  grain  at  $30  per  ton)  37  cents  per  cow. 

For  40  cows,  food  cost  per  day  equals  .......  $14  80 

A  building  for  housing  stock  and  hay  will  average  to  cost  $100  per  cow; 

interest  on  $4,000  at  5  per  cent,  equals  per  day,           ....  60 

Depreciation  of  building  at  5  per  cent,  per  year  equals  per  day,        .          .  60 
Depreciation  of  cows  and  loss  in  replacing  equals  per  day   (low  esti- 
mate),   .....      \   ......          .  75 

Taxes  on  building  and  cows  (not  on  land)  per  day,          ....  30 

Milking  40  cows  at  20  cents  per  hour  equals  per  day,      .          .          .  1  60 

Grooming  40  cows  equals  per  day,         .......  40 

Cleaning  stables  and  feeding  per  day,   .......  60 

Wear  and  tear  of  small  tools,  currycombs,  brooms,  etc.,  including  service 

of  bull,  cost  of  city  water,  veterinary  fees,  ice,  light,  etc.,     .          .          .  15 


$19  80 


Against  this  we  have  a  credit  of  $2.50  per  day  for  manure  and  30  cents 

per  day  for  calves  born  during  the  year  (calves  at  $3  each  at  birth) ,      .         2  80 


Net  cost  for  40  cows  per  day,         .......     $17  00 

For  more  than  fifteen  years  we  have  weighed  every  cow's  milk  both 
morning  and  night,  and  our  records  show  that  our  cows  (and  we  keep 
none  that  give  less  than  5,000  pounds  per  year)  average  just  about  7 
quarts  per  day.  Forty  cows,  then,  will  average  to  produce  280  quarts 
of  milk  per  day  at  an  average  daily  cost  of  $17,  or  a  trifle  over  6  cents 
per  quart. 

By  substituting  30  pounds  of  ensilage  for  15  pounds  of  hay  in  the 
daily  ration  of  each  cow  we  are  able  to  cut  the  cost  to  about  5  cents  per 
quart,  but  the  closest  scrutiny  will  not  reveal  any  other  item  where  a 
saving  can  be  made. 

That  Mr.  Howe's  figures  are  not  too  high  is  obvious  when 
we  consider  that  he  has  made  no  account  of  waste  in  handling, 
superintendence  or  profits  beyond  interest  at  5  per  cent. 

Prof.  John  M.  Trueman,  formerly  of  the  Connecticut  Agri- 
cultural College,  Storrs,  Conn.,  says:  — 


92 


Cost  of  Feeding. l 

Silage,  4  tons  at  $4, $16  00 

Hay,  1J  tons  at  $16 24  00 

Grain,  1 J  tons  at  $30 37  50 

Pasture,  four  months,           .          .          .          .          .          .          .          .  8  00 

Total $85  50 

In  years  when  pasture  is  short,  and  grain  and  silage  or  green  fodder 
must  be  fed  all  summer,  the  cost  per  year  "will  frequently  go  up  as  high 
as  $100. 

The  total  cost  of  keeping  each  cow  per  j^ear,  therefore,  is  as  follows:  — 


Feed 

Bedding,    ..... 

Keep  of  bull  (for  herd  of  25  cows) , 

Taxes  on  cow  and  barn, 

Interest  on  money  invested  in  cows, 

Barn  rent,  .... 

Insurance,  .... 

Depreciation  of  cow,  . 

Light,  medicine,  etc., 

Labor,        ..... 

Total 


$85  00 


5 

00 

3  00 

1 

25 

3 

75 

3 

00 

40 

13 

00 

2 

00 

33 

60 

$150  00 


The  cows  thus  fed  and  cared  for  included  Jerseys,  Guernseys,  Ayr- 
shires  and  Holsteins.  Some  were  very  good  producers,  others  only  fair. 
The  average  for  the  whole  lot  for  the  five  years  was  6,378  pounds  per 
cow,  which,  on  the  basis  of  2\  pounds  to  the  quart,  is  equal  to  2,834 
quarts.  Although  this  is  not  a  heavy  yield,  it  is  a  good  average  for  a 
herd  of  25  cows  made  up  of  several  breeds.  It  requires  extra  skill  and 
good  management  to  increase  the  yield  beyond  this  point.  When  it  is 
remembered  that  the  average  yearly  production  for  the  New  England 
States  is  less  than  2,200  quarts  per  cow,  it  will  seem  that  a  herd  making 
over  2,834  is  doing  fairly  well.  It  is  useless,  therefore,  to  hope  to  de- 
crease the  cost  of  milk  by  much  further  increase  in  the  yearly  production 
of  the  cows.  Any  material  increase  over  3,000  quarts  in  a  large  herd 
comes  high  from  the  necessary  weeding  out  of  ordinary  producers  and 
the  small  numbers  of  high  producers  to  be  found. 

The  cow  should  be  credited  with  her  calves  and  with  the  manure  she 
makes.  We  cannot  allow  more  than  $5  per  year  for  calves,  nor  more 
than  $10  per  year  for  manure  in  the  barnyard.  We  can,  therefore,  credit 
the  cow  with  $15.  and  subtract  that  amount  from  the  $150  that  it  cost 
to  keep  her.  This  leaves  $135  to  be  balanced  by  2,834  quarts  of  milk, 
which  would  require  the  milk  to  be  sold  at  the  farmer's  door  for  practically 
4.75  cents  per  quart.    This  amount  simply  pays  for  the  actual  cost  of 


1  These  figures  represent  the  average  cost  of  five  years,  1907-11,  and  are  somewhat  too  low  for 
1913. 


93 


the  investment  and  labor  put  on  the  milk.  It  allows  nothing  for  the 
farmer's  skill  as  manager,  nor  for  the  extra  hours  he  must  work  planning 
for  the  improvement  of  his  herd  and  the  running  of  the  business,  and 
nothing  for  the  profits.  He  has  simply  received  5  per  cent,  on  his  in- 
vestment and  common  laborer's  wages. 

If  he  is  going  to  improve  his  farm  and  build  up  a  permanent  agriculture 
in  an  advancing  rural  community,  and  continue  in  business,  he  will 
require  5.75  cents  or  more  per  quart  to  pay  the  bill. 

Fred  Rasmussen,  professor  of  dairying,  New  Hampshire 
Agricultural  College,  Durham,  N.  H.,  says:  — 

The  last  census  report  shows  the  average  production  of  milk  per  cow 
in  Massachusetts  to  be  4,524  pounds,  in  New  Hampshire  3,775  pounds, 
in  Vermont  3,982  pounds.  No  doubt  the  actual  production  in  the  several 
States  is  higher  than  this.  In  the  writer's  opinion  a  more  nearly  correct 
estimate  is  between  5,000  and  5,500  pounds  of  milk. 

To  get  conditions  which  will  represent  average  production  for  Mas- 
sachusetts, New  Hampshire  and  Vermont  let  us  take  the  39  cows,  of 
the  26  herds1  studied,  producing  between  5,500  and  6,000  pounds  with 
an  average  production  of  5,540  pounds  of  milk. 


The  Cost  of  Production. 
Cost  of  feed, 2 
Labor, 
Delivery,  . 
Housing,    . 
Depreciation, 
Bedding,    . 
Bull, 

Taxes  and  interest, 
Ice,  coal  and  wood  for  heating, 
Veterinary  service  and  medicine, 
Tools,  utensils,  salt,  etc., 


$66  91 

32  33 

6  16 

9  05 

8  83 


00 
79 
55 
17 
87 
53 


$139  19 
Credit:  — 

Manure $15  00 

Calf, 3  00 

18  00 ( 

Total $121  19 

1  See  Circular  No.  8  of  this  series;  also  Bulletin  No.  2,  New  Hampshire  College  and  Experiment 
Station. 

2  It  costs  less  to  feed  these  "average"  cows  than  it  does  higher  producers,  which  accounts  for 
the  difference  in  figures  here  given  from  those  used  in  Circular  No.  8. 


94 


Comparison  of  Increase  in  Cost  of  Production  with  Increase  in 
Price  obtained  by  Farmer. 

The  following  table  gives  comparison  of  cost  of  feeds  and 
prices  received  for  milk,  1904  to  1912.  The  prices  are  those  of 
the  Boston  Chamber  of  Commerce,  and  records  compiled  by 
J.  B.  Lindsey.  The  price  of  milk  per  quart  to  the  farmer  is  the 
price  paid  in  the  middle  zone  by  one  of  the  largest  milk  con- 
tractors in  Boston.  The  price  paid  by  the  consumer  for  milk 
is  the  price  paid  for  milk  delivered  in  glass  bottles  for  family 
use  in  Boston. 


95 


Con- 
sumer's 
Price  per 
Quart 
(Cents). 

7.50 
9.00 

20.0 

Farmer's 

Price 
per  Quart 

(Cents). 

3.24 
3.9 

20.4 

Cotton- 
seed Meal 
per  Ton. 

$26  52 
$31  20 

27.6 

Corn 

Meal  per 

Ton. 

$23  68 
$30  20 

27.5 

a  g 

0T3O 

$24  24 
$31  51 

29.9 

c  o 

n 

$20  87 
$27  96 

34.4 

"in  a  & 
o  C  o 

.SO  S3 

Q      » 

$24  31 
$39  94 

35.5 

(n  on 

$25  17 
$39  30 

56.2 

d 

>> 

w 

$13  00  to  $16  50 
$21  50  to  $28  00 

57.7  to  64.7 

si 
g 

« 
< 

Prices  in  1904, 
Prices  in  1912, 

Increase  in  per  cent., 

96 


Professor  Lindsey  gives  the  following  figures  on  the  cost  of 
production  of  131  cows  from  1896  to  1911 


Average  yearly  food  cost  per  cow, 

Net  yearly  fixed  charges  per  cow  (estimated), 

Total  cost  per  cow,       .... 

Average  yearly  yield  per  cow  (pounds), 

Average  yearly  yield  per  cow  (quarts) , 

Cost  of  milk  (100  pounds), 

Cost  of  milk  (1  quart)  (cents),    . 


$89  24 

$56  00 

$145  24 

6,036.3 

2,683 

$2  41 

5.43 


Financing  the  Cow. 
Few  people  have  any  idea  what  it  costs  to  finance  the  cow. 
We  know  of  no  New  England  data  upon  the  subject.  The  New 
York  Experiment  Station  at  Geneva  has  made  a  study  of  this 
question  as  applied  to  the  milk  supply  of  that  city,  and  Bulle- 
tin No.  563  says:  — 

Considered  from  the  agricultural  standpoint,  the  capitalization  amounts 
to  $763  per  cow,  of  which  the  producer  furnished  $680  and  the  retailer 


In  other  words,  it  costs  the  milk  producers  supplying  milk 
to  Geneva,  N.  Y.,  a  city  of  about  13,000  inhabitants,  $680  to 
finance  each  cow,  and  it  costs  the  distributors  $83  to  finance 
the  distribution  of  the  milk  of  each  cow. 

The  capital  invested  was  estimated  as  follows :  — 

600  cows  at  $80, $48,000 

3,000  acres  of  land  with  buildings, 300,000 

Equipment,  $20  per  acre, .        .       .       60,000 

$408,000 
Capital  invested  in  distribution, 50,000 

Total, $458,000 

That  the  Massachusetts  dairyman  is  progressive  is  evidenced 
by  figures  of  milk  production  in  Massachusetts  as  compared 
with  the  States  of  Vermont  and  New  Hampshire. 

Professor  Rasmussen  says  that  the  average  annual  produc- 
tion per  cow  in  those  States  is  as  follows :  — 

Pounds . 

Massachusetts, 4,524 

Vermont, 3,982 

New  Hampshire, 3,775 


97 

Assuming  that  a  quart  of  standard  milk  weighs  2.15  pounds, 
the  production  in  quarts  per  day  would  be  — 

Quarts. 

Massachusetts, 5f 

Vermont, 5 

New  Hampshire, 4.8 

These  figures  are  interesting  in  view  of  the  fact  that  Ver- 
mont has  generally  been  considered  the  dairy  State  of  New 
England. 

An  interesting  feature  is  the  belief  of  admirers  of  different 
thoroughbred  varieties  of  cattle  that  the  breed  which  they  ad- 
mire is  the  best  for  certain  purposes,  which  ideas  are  not  always 
substantiated  by  facts.  Too  much  emphasis  is  laid  on  individ- 
ual work  and  not  enough  on  herd  work;  as,  for  instance,  in 
the  Holstein  breed  the  herd  records,  so  far  as  we  have  them, 
are  in  no  way  comparable  with  individual  records,  and  it  is 
a  mistake  to  think  that  thoroughbred  herds  exceed  in  produc- 
tion, to  any  great  extent,  the  good  herds  of  grade  cows;  at 
least,  the  observation  of  the  committee  has  shown  it  thus. 

That  there  are  fads  and  fashions  in  all  things  is  just  as  true 
of  the  dairy  business  as  of  other  things,  and  many  a  dairyman 
owes  a  part  of  his  failure  in  dairying  to  the  fact  that  he  has 
been  caught  by  a  fad. 

Fads  in  feediag  cattle  have  followed  a  knowledge  acquired 
after  patient  study  and  research  by  competent  persons,  by 
parties  who  have  absorbed  only  a  part  of  the  idea  and  have 
had  the  benefit  of  other  conditions  to  help  them  out  for  a 
while;  but  when  the  favorable  elements  have  been  removed 
they  found  that  the  profits  have  been  wiped  out  by  wasteful 
and  injudicious  feeding  methods,  also  by  dairymen  following 
ration  formula?  used  by  gentlemen  farmers  and  others  in  trials 
for  advance  registry  records.  Such  fads  and  heavy  feeding 
methods  have  resulted  in  very  many  cases  of  udder  troubles 
that  seriously  affect  the  quality  of  the  milk  from  such  cows, 
both  from  a  health  standpoint  and  also  a  commercial  point  of 
view,  as  well  as  being  a  deteriorating  factor  in  the  value  of 
the  cow. 

If  there  has  been  a  profit  in  milk  production  in  Massachu- 
setts in  the  last  few  years  among  those  dairymen  who  sell 
their  product  to  the  large  dealers,  it  has  been  among  those 


98 

who  raise  the  largest  proportion  of  the  stock  feed  on  their  own 
place.  This  class  of  producers,  that  is,  the  ones  who  raise  most 
of  the  fodder  and  a  good  part  of  the  grain  used  in  feeding  their 
herds,  do  not  as  a  general  thing  produce  as  much  milk  or  cream 
as  those  who  buy  and  feed  generously  the  high  concentrates 
now  common  in  the  markets;  but  they  do  keep  a  larger  part 
of  the  gross  receipts  in  their  own  pockets,  and  the  cattle  fed 
in  the  old-fashioned  way  are  almost  invariably  healthier  and 
remain  producers  longer  than  the  highly  pampered  and  fed 
cattle.  Cases  of  milk  fever,  garget  and  other  udder  troubles, 
and  also  tuberculosis,  are  less  prevalent  in  herds  that  have  not 
been  crowded. 

The  old-fashioned  way  spoken  of  is  the  one  followed  by  many 
Worcester  County  farmers  formerly,  and  by  a  less  number  now, 
and  the  ration  is  generally  composed  of  hay,  clover  and  cut 
dry  corn  stalks  for  roughage,  turnips  and  mangles  for  succulent 
feed,  and  the  field  corn  ground  into  what  is  called  cob  grist,  — 
that  is,  the  whole  ear  is  ground  and  fed  as  meal  with  some  of 
the  wheat  feeds,  such  as  bran  or  mixed  feed,  —  and  by  this 
method  of  feeding,  which  gives  a  good  nutritive  ratio,  the  high- 
est natural  production  can  be  obtained.  Any  crowding  with 
concentrates  is  unnatural,  and  requires  the  best  efforts  of  an 
expert  cattle  feeder  to  keep  the  herd  in  good  shape. 

Large  and  Small  Herds. 

The  cost  of  maintaining  a  large  herd  of  cattle  is  less  in  pro- 
portion in  some  ways  and  not  in  others,  for  while  any  large 
business  is  done  on  a  more  economical  basis  than  a  small  one 
when  materials  are  bought,  still,  the  smaller  dairies  that  are 
run  in  conjunction  with  general  farming  are  sometimes  more 
profitable  in  proportion,  as  they  provide  something  for  the 
farmers  to  do  in  the  winter  time  when  other  lines  of  his  busi- 
ness are  at  a  standstill. 

Condensed  and  Evaporated  Milk  and  Milk  Powders. 

An  Interview  with  Mr.  W.  J.  Reid,  Local  Manager  for 

the  Van  Camp  Company. 

Mr.  Reid  says  that  the  Van  Camp  Company's  business  in 

evaporated  milk  increased  at  least  100  per  cent.,  perhaps  125 

per  cent.,  from  1906  to  1914,  and  that  the  business  was  very 


99 

profitable  from  1906  to  1912.  Since  1912  there  has  been  no 
profit  in  the  evaporated  milk  business,  owing  to  the  increased 
cost  of  everything  used  in  the  manufacture  and  shipping  and 
to  the  scarcity  of  milk.  The  Van  Camp  evaporating  plants 
have  been  running  half  time  recently,  owing  to  the  scarcity, 
and  in  1910  a  large  plant  that  the  company  was  running  at 
St.  Albans,  Vt.,  was  discontinued,  as  not  enough  milk  could  be 
obtained  to  make  it  profitable.  Mr.  Reid  says  that  the  cases 
in  which  the  evaporated  milk  is  packed  now  cost  18  cents 
apiece  where  formerly  they  were  bought  for  5  cents  apiece. 
The  cans  used  in  putting  up  the  milk  cost  at  least  40  per  cent, 
more  than  a  few  years  ago.  The  labels  also  have  increased  in 
price,  and  there  has  been  a  considerable  increase  in  the  price 
paid  for  labor,  but  in  spite  of  these  increased  costs  the  price  of 
evaporated  milk  per  case,  for  the  year  1915  averaged  S3  a 
case,  against  a  price  of  $3.55  per  case  in  1912.  Mr.  Reid  made 
the  statement  that  his  firm  believed  that  there  was  no  profit 
in  the  evaporated  milk  business  at  the  present  time  (1915),  nor 
would  there  be  any  until  the  consumers  were  willing  to  pay  more 
than  they  do.  Keen  competition  among  the  manufacturers  of 
evaporated  milk  made  it  impossible  to  do  anything  in  a  general 
way  toward  advancing  prices.  Mr.  Reid  said  that  the  evapo- 
rated milk  business  was  the  only  one  of  their  many  lines  where 
the  manufactured  product  did  not  respond  to  the  market  price 
of  the  raw  material,  and  said  that  all  other  lines  that  they 
handle  were  advanced  or  lowered  in  price  to  correspond  with 
market  conditions.  For  instance,  their  best  brand  of  baked 
beans  is  now  selling  for  20  cents  per  can  instead  of  14  cents  as 
formerly,  and  this  is  due  to  the  advanced  price  of  the  raw  bean. 

Interview  with  Mr.  George  Wm.  Bentley,  Agent  for 
the  Borden  Condensed  Milk  Company. 
Mr.  Bentley  says  that  at  the  present  time  the  condensed  milk 
business  is  not  in  a  very  satisfactory  condition;  that  it  is  im- 
possible for  him  to  get  enough  condensed  milk  from  the 
factories  to  fill  their  regular  orders;  that  the  reason  for  this  is 
the  scarcity  of  the  raw  product;  and  that  so  scarce  is  the  fluid 
milk  for  manufacturing  into  condensed  milk  that  their  com- 
pany is  now  going  into  Canada  for  more  milk  and  to  open 
manufactories.     He  also  says  that  until  within  two  years  the 


100 


condensed  milk  business  had  increased  at  the  rate  of  about 
15  per  cent,  per  year  since  1906,  but  that  it  was  now  falling 
off  almost  as  fast  as  it  had  increased  up  to  1912.  Part  of  this 
decrease  is  due  to  the  fact  that  there  is  a  less  demand,  and 
part  to  the  above-mentioned  shortage  of  the  raw  milk.  Mr. 
Bentley  said  that  the  less  demand  by  the  public  might  be  due 
to  the  financial  conditions  of  the  past  few  years,  but  did  not 
see  why  there  should  have  been  any  idea  that  this  was  economy, 
as  he  considered  that  the  public  was  getting  more  for  their 
money  when  they  bought  milk  or  any  of  its  products  than  in 
any  other  line  of  food.  Mr.  Bentley  very  kindly  offered  to  give 
the  Milk  Board  figures  to  show  the  amount  of  condensed  milk 
his  firm  had  handled  for  several  years  back.  These  figures 
have  not  yet  been  acquired  by  the  Milk  Board. 

Interview   with   Mr.   Louis   W.   de   Pass,   in  Charge   of 
Statistics  at  the  Boston  Chamber  of  Commerce. 

Mr.  De  Pass  gave  the  figures  on  the  amount  of  condensed, 
evaporated  and  powdered  milk  coming  into  Boston  for  the 
years  1912,  1913  and  1914,  with  the  amount  from  Jan.  1  to 
Nov.  1,  1915.  Mr.  De  Pass  only  began  to  keep  these  figures 
in  the  year  beginning  1912.    The  amounts  are  as  follows:  — 


Cases. 


Barrels. 


1912 

1913 

1914 

Jan.  1  to  Nov.  1,  1915, 
Jan.  1  to  Nov.  1,  1914, 
November,  1914,  . 
December,  1914,  . 


321,946 

2,304 

321,883 

3,484 

432,601 

851 

326,474 

5,145 

355,932 

606 

34,253 

40 

42,416 

205 

In  the  opinion  of  Mr.  De  Pass  there  has  been  a  decided 
increase  in  the  amount  of  condensed  and  evaporated  milk 
handled  for  the  last  few  years,  and  he  did  not  think  that  the 
financial  conditions  of  the  last  few  years  had  caused  any 
decrease  in  the  amount  of  this  product  coming  into  the  city  of 
Boston. 


101 

The  figures  quoted  are  made  up  from  the  dairy  returns  of  all 
the  railroads  running  into  Boston,  and  are  said  to  be  accurate, 
but  there  has  been  no  attempt  made  to  separate  the  different 
kinds  of  milk  preparations. 

Comments  on  Milk  Production. 

Although  considerable  time  has  been  spent  in  the  investi- 
gation of  the  different  factors  entering  into  the  business  of  milk 
production,  it  is  by  no  means  certain  that  enough  information 
has  been  gathered  from  which  to  draw  conclusions  as  to  the 
exact  condition  of  milk  production  in  .  Massachusetts,  and  it 
would  be  unwise  to  make  any  efforts  toward  the  regulations  of 
the  dairy  business  from  a  health  or  any  other  standpoint  until 
the  findings  of  this  investigation  have  been  carefully  reviewed, 
as  there  is  a  possibility  that  the  dairy  business  in  Massachusetts 
is  in  danger  of  becoming  almost  entirely  eliminated  unless 
something  is  done  to  restore  confidence. 

A  study  of  the  census  reports  shows  that  in  all  of  the  New 
England  States,  except  Rhode  Island,  there  has  been  a  great 
decrease  in  the  number  of  milch  cows  kept,  this  decrease  being 
most  pronounced  since  1890;  that  the  consuming  public  of 
Massachusetts  has  been  obliged  to  use  milk  from  dairies  far 
beyond  the  points  where  the  milk  supply  was  formerly  ob- 
tained; and  that  the  distance  has  steadily  increased  and  nearby 
production  has  steadily  decreased,  so  that  it  would  appear 
as  though  the  future  generations  would  have  but  a  small 
amount,  if  any,  of  milk  from  near-by  points, 

If  milk  is  an  important  article  of  food,  and  if  the  quality  is 
at  all  an  important  feature,  it  is  evident  that  it  becomes  neces- 
sary that  the  near-by  production  of  milk  should  receive  such 
encouragement  as  can  be  given.  Although  the  milk  business 
owes  its  principal  decline  to  strictly  commercial  causes,  it  must 
be  revived  for  more  important  reasons  than  that  of  commercial 
interest,  and  one  of  the  most  important  and  vital  reasons  is 
the  preservation  of  the  life  and  health  of  our  people. 

That  milk  is  a  necessary  article  of  diet  is  admitted  by  all, 
and  its  importance  in  the  diet  of  infants  and  invalids  is  incal- 
culable, because  on  the  use  of  cow's  milk  depends  the  lives  of 
many,  who,  from  unavoidable  causes,  are  compelled  to  rely  on 


102 

it  for  varying  periods  of  time.  It  is  said  by  several  authorities 
that  breast  feeding  of  infants  is  on  the  decline  in  this  country, 
and  if  that  is  a  fact,  then  we  must  depend  more  and  more  on 
the  cow  to  provide  sustenance  for  those  who  unfortunately  are 
denied  their  natural  food. 

If  the  statistics  in  regard  to  milk  production  gathered  during 
this  investigation  are  correct,  and  we  believe  them  to  be  so, 
then  we  must  be  approaching  at  a  greater  or  less  rate  of  speed 
the  time  when  a  good  quality  of  cow's  milk  for  our  infants' 
nourishment  will  become  a  rare  and  consequently  high-priced 
article.  It  therefore  seems  as  though  the  complaints  of  the 
future  would  be  numerous  in  regard  to  the  milk  situation,  but 
along  distinctly  different  lines  than  at  present.  If  the  produc- 
tion of  milk  within  a  reasonable  distance  of  the  city  of  Boston 
shall  decrease  as  fast  in  the  next  twenty-five  years  as  it  has 
in  the  past  twenty-five  years,  and  the  farmers  in  zones  that  are 
now  supplying  a  large  part  of  the  milk  which  was  formerly 
produced  nearer  Boston  become  convinced  of  the  fact  that  milk 
production  is  a  financial  failure  under  prevailing  conditions  (and 
personal  interviews  with  many  producers  of  those  zones  have 
shown  us  that  the  more  thoughtful  ones  believe  this  to  be  the 
case),  it  is  only  a  question  of  time  when  we  will  have  no  ade- 
quate locally  produced  milk  supply  suitable  for  infants,  invalids 
or  those  who  need  it  as  an  article  of  daily  diet. 

It  has  been  suggested  by  some  farmers  that  the  best  way  to 
remedy  the  financial  conditions  under  which  producers  labor  ' 
at  the  present  time,,  and  have  for  some  time  in  the  past,  is  for 
the  dairymen  to  cease  the  production  of  milk  and  go  into  other 
and  more  remunerative  lines  of  agriculture,  with  the  expecta- 
tion that  a  shortage  in  the  supply  of  milk  would  bring  an  ad- 
vance in  prices  that  would  make  the  production  of  milk  a  pay- 
ing line  of  agriculture.  This  idea,  however,  is  probably  an 
erroneous  one,  for  it  is  well  known  that  those  dairymen  who 
have  given  up  milk  production  and  have  engaged  in  vegetable, 
fruit  or  poultry  raising,  or  other  agricultural  lines,  have  seldom 
returned  to  dairying  because  it  is  much  more  exacting  in  regard 
to  hours  and  close  application  throughout  a  whole  year  than 
is  the  production  of  seasonable  crops  or  poultry  husbandry; 
and  also  because  a  return  to  the  dairy  industry  means  either 


103 

a  large  outlay  of  money  at  the  start  or  a  slow  process  of  build- 
ing up  a  herd  with  which  to'  do  business. 

An  important  reason  why  the  dairy  business  should  be  en- 
couraged is  that  all  other  lines  of  agriculture  depend  largely 
on  the  animal  fertilizers  for  best  results  in  growing  farm  crops, 
and  except  in  a  small  percentage  of  cases  farms  certainly  do 
run  down  and  become  less  productive  where  the  animal  fer- 
tilizers are  lacking. 

It  is  a  fact  that  some  farms  have  been  successfully  run  on 
commercial  fertilizers  and  green  manures,  but  it  does  not  seem 
probable  that  the  method  will  ever  become  general,  as  it  re- 
quires more  than  the  ordinary  amount  of  scientific  knowledge 
of  chemistry,  etc.,  than  we  can  expect  to  find  among  our  com- 
mon farmers. 

Agriculture  along  the  lines  now  common  in  our  New  England 
States  must  be  fostered  if  we  are  to  continue  to  have  a  supply 
of  the  native-grown  fruits  and  vegetables  that  we  are  accus- 
tomed to,  and  no  one  should  dispute  the  statement  that  New 
England  quality  in  all  lines  of  fruits  and  vegetables  native  to 
these  States  is  high. 

The  working  classes  are  the  ones  who  must  bear  the  burden 
of  the  high  cost  of  living,  and  to  them  any  advance  in  price  of 
any  necessary  article  of  food  is  of  great  importance,  and  it  is 
very  necessary  that  in  the  study  of  conditions  relating  to  the 
production  of  milk  due  consideration  should  be  given  this  part 
of  the  subject. 

The  lack  of  uniformity  in  the  price  paid  to  producers  of  milk 
whose  output  comes  into  the  Massachusetts  market  is  appar- 
ent, and  the  Milk  Board  has  found  in  their  investigation  that 
the  amount  paid  per  8^-quart  can  varies  from  25  to  56  cents 
per  can  in  different  sections  of  New  England,  but  as  only  a 
small  part  of  the  total  is  sold  for  the  latter  price  it  is  very  dif- 
ficult to  say  what  the  average  price  may  be.  The  estimated 
average  price  paid  is  31  cents  per  8^-quart  can,  and  the  esti- 
mated average  price  to  the  consumers  is  9  cents  per  quart,  or 
about  75  cents  per  8|-quart  can.  Our  investigation  has  shown 
that  the  retail  price  of  milk  of  the  ordinary  market  quality 
varies  from  6  cents  per  quart  in  the  town  of  Great  Barring- 
ton  to  12  cents  per  quart  in  the  towns  on  Cape  Cod,  where 


104 

the  greater  part  of  the  milk  is  produced  in  the  summer  season 
to  be  sold  to  summer  residents.  Certified  milk  seems  to  be 
a  small  part  of  the  total  amount,  probably  less  than  1  per 
cent.,  and  the  prices  are  said  to  vary  from  12  to  20  cents  per 
quart,  although  a  small  amount  is  sold  at  a  higher  price.  It 
has  been  ascertained  that  producers  in  the  State  of  Maine  are 
paid  a  much  better  price  for  milk  by  a  large  concern  doing  the 
principal  business  in  that  section  than  are  producers  in  other 
sections  equally  distant  from  Boston  who  deal  with  other  com- 
panies. There  is  also  a  lack  of  uniformity  in  deducting  the 
transportation  charges  from  what  is  called  the  Boston  price, 
which  transportation  charges  vary  in  the  different  zones. 

It  is  said  that  in  some  instances  milk  is  transported  by  rail- 
road twice  as  far  for  a  given  price  as  it  is  in  others,  which,  of 
course,  must  increase  the  unfavorable  conditions  surrounding 
the  milk  industry. 

The  management  of  the  Boston  &  Maine  Railroad  has  re- 
cently petitioned  the  Massachusetts  Public  Service  Commission 
for  permission  to  increase  rates  for  hauling  milk,  but  nothing 
has  been  done  along  this  line,  as  it  has  been  claimed  by  some 
of  the  interested  parties  that  it  is  an  interstate  question,  and 
must  be  settled  by  the  United  States  Interstate  Commerce 
Commission. 

In  one  of  the  Boston  Sunday  papers  of  Jan.  9,  1916,  a  state- 
ment was  made  that  the  Interstate  Commerce  Commission  is 
to  make  an  investigation  of  milk  transportation  rates  in  the 
New  England  States. 

Any  increase  in  transportation  rates  at  this  time  must  mean 
an  increased  price  to  the  consumer,  as  the  producers  cannot 
stand  a  smaller  price  than  they  are  now  receiving,  and  the 
dealers  have  stated  that  they  cannot  do  business  on  a  smaller 
margin  of  profit  than  that  which  they  now  receive. 

A  study  of  one  of  the  accompanying  charts  shows  the  values 
of  some  of  the  principal  agricultural  crops  of  the  United  States, 
and  also  that  dairy  products  rank  high  in  vaiue.  When  we 
consider  that  where  dairying  declines  other  agricultural  lines 
suffer  great  loss,  and  where  agriculture  is  neglected  or  becomes 
unprofitable  all  business  lines  almost  instantly  respond  to  the 
decline,   and  if  agricultural  work  is  profitable  then  all   other 


105 

business  lines  are  profitable,  we  are  justified  in  considering  that 
dairying  is  an  important  industry  in  Massachusetts. 

To  give  an  idea  of  the  financial  importance  of  dairying  in 
Massachusetts  the  following  figures  are  given:  147,000  milch 
cows  at  an  average  value  of  $60  each  equals  $8,820,000;  147,000 
cows  yielding  5f  quarts  per  day  each  at  a  value  of  4  cents  per 
quart  equals  $33,800  per  day;  $33,800  per  day  multiplied  by 
365  equals  $12,307,000  per  year,  as  a  rough  estimate  of  the 
value  of  the  present  milk  production  in  Massachusetts.  Using 
figures  of  the  New  York  Experiment  Station  on  financing  the 
cow,  147,000,  cows  at  $680  each  equals  $99,960,000  to  finance 
the  cows  of  this  State. 

If  we  estimate  the  number  of  people  employed  in  caring  for 
the  milch  cows  of  this  State  as  1  person  per  8  cows,  we  have 
18,375  persons  daily  employed  in  this  work.  These  figures  show 
the  dairy  industry  of  Massachusetts  to  be  important,  and  al- 
though it  is  impossible  to  say  what  the  effect  of  the  elimination 
of  dairying  in  Massachusetts  would  be,  it  would  certainly  have 
a  very  depressing  effect  on  other  lines  of  business  activity.  Any 
increase  in  the  dairy  industry  of  Massachusetts  must  certainly 
tend  toward  a  greater  prosperity  for  all  connected  with  the 
agricultural  interests  of  the  Commonwealth  and  for  those  firms 
or  individuals  who  rely  upon  the  residents  of  the  rural  districts 
for  their  commercial  success. 

D.    THE    COMMERCIAL    PASTEURIZATION    OF    MILK    AND 

CREAM. 

Pasteurization  is  the  term  applied  to  the  process  of  heating 
a  substance  to  a  temperature  sufficiently  high  to  destroy  or 
greatly  reduce  the  bacterial  content  without  causing  appreciable 
chemical  changes  in  the  substance.  The  commercial  pasteuriza- 
tion of  milk  as  generally  carried  out  in  the  State  of  Massachu- 
setts consists  in  heating  the  milk  to  a  temperature  of  145°  or 
150°  F.,  and  holding  the  heated  milk  at  a  temperature  of  142° 
to  144°  F.  for  a  period  of  from  twenty  to  thirty-five  minutes, 
after  which  it  is  immediately  cooled.  In  a  few  instances,  how- 
ever, dealers  still  employ  the  flash  process  of  pasteurization, 
by  which  the  milk  is  momentarily  heated  at  a  higher  tempera- 
ture and  is  immediately  cooled. 


106 

In  the  milk-pasteurization  plants  the  milk  is  heated  very 
quickly,  generally  under  automatic  temperature  control  and 
record;  after  which  it  is  transferred  to  the  holding  chambers 
which  may  be  of  the  continuous  or  of  the  intermittent  type. 
,In  either  case  the  temperature  of  the  milk  is  usually  recorded 
as  the  milk  leaves  the  chambers  for  the  cooler.  In  a  few  in- 
stances the  milk  is  heated  slowly  in  bulk,  and  held  at  the  tem- 
perature of  pasteurization  for  the  necessary  time  in  the  same 
tank  in  which  it  was  heated,  after  which  it  is  cooled  and  bot- 
tled in  the  usual  manner. 

The  sale  of  milk  heated  to  a  temperature  greater  than  167° 
F.  is  prohibited  in  Massachusetts  unless  labeled  "Heated  Milk." 
This  statute  is  difficult  of  enforcement,  as  it  is  almost  impos- 
sible to  determine  by  laboratory  methods  the  exact  tempera- 
ture to  which  milk  has  been  heated,  and  in  order  to  obtain  the 
necessary  evidence  to  prosecute  for  a  violation  of  this  law  the 
investigator  must  see  the  milk  pasteurized,  and  must  of  his 
own  knowledge  know  the  temperature  to  which  the  milk  was 
heated. 

The  first  noticeable  effect  of  heat  upon'  milk  is  the  production 
of  a  cooked  taste  which,  however,  depends  to  a  large  measure 
upon  the  temperature  of  heating.  If  the  temperature  is  not 
too  high  this  taste  will  disappear  in  eighteen  or  twenty  hours. 
The  chemical  effect  of  heat  on  milk  is  the  destruction  of  the 
so-called  enzymes,  and,  as  the  temperature  is  increased,  the 
coagulation  of  the  albumin,  and  if  a  temperature  greater  than 
the  boiling  point  is  reached  the  sugar  may  be  caramelized. 
The  exact  nature  and  significance  of  the  enzymes  present  is  a 
matter  of  controversy  among  those  scientists  who  are  trying  to 
solve  the  problem,  but  a  study  of  the  literature  shows  that 
milk  gives  reactions  which  may  be  explained  by  the  presence 
of  enzymes.  Under  this  assumption  it  may  be  stated  that  raw 
milk  contains  a  diastase  capable  of  hydrolizing  0.01  to  0.02 
per  cent,  of  starch,  a  catalase  which  will  liberate  oxygen  from 
hydrogen  dioxide,  a  peroxidase  which  will  cause  hydrogen 
dioxide  to  react  with  certain  organic  substances,  thereby  pro- 
ducing colors,  and  reductases  capable  of  reducing  methylene 
blue  solutions  to  a  colorless  compound.  These  reactions  are 
not  only  influenced  by  the  temperature  to  which  the  milk  is 


107 

heated,  but  by  the  length  of  time  during  which  the  temperature 
is  maintained,  and  also  by  the  age  of  the  milk.  The  diastase 
is  destroyed  by  commercial  pasteurization,  and  this  is  also  true 
of  the  formalin-methylene  blue  reductase,  but  this  latter 
reaction  returns  three  days  after  pasteurization,  probably  the 
reacting  substance  being  reproduced  by  the  growth  of  bacteria. 
The  peroxidase  reaction  is  not  affected  by  the  commercial 
pasteurization  of  milk,  as  shown  by  the  work  performed  with 
this  reaction  in  the  Food  and  Drug  Laboratory  of  the  Massa- 
chusetts State  Department  of  Health  during  the  year  1913. 

As  the  destruction  of  this  reaction  is  coincident  with  the 
coagulation  of  the  albumin,  and  since  the  reaction  may  be  a 
function  of  the  albumin,  it  follows  that  there  is  undoubtedly  no 
change  in  the  milk  proteins  by  commercial  pasteurization  as 
now  practiced.  When  it  is  considered  that  milk  with  a  cooked 
taste  is  liable  to  have  a  limited  sale  it  is  evident  that  the  milk 
dealers  will  endeavor  to  keep  the  temperature  as  low  as  they 
possibly  can  and  produce  the  required  results.  An  added 
incentive  to  keep  the  temperature  of  pasteurization  low  is  the 
fact  that  if  milk  is  heated  to  a  high  temperature  the  cream 
does  not  rise  well,  and  the  bottle  of  milk  will  not  show  the 
cream  line  by  which  the  public  judge  the  quality  of  the  milk 
they  receive. 

Proper  pasteurization  will  cause  an  enormous  reduction  in 
the  bacterial  content  of  milk,  and,  owing  to  the  fact  that 
pathogenic  bacteria  are  killed  at  a  lower  temperature  than 
most  forms  of  lactic  acid  bacteria,  the  milk  is  rendered  safe  for 
food  purposes  and  yet,  provided  that  the  temperature  is  not  too 
high,  is  capable  of  going  through  the  usual  form  of  fermentation 
common  to  raw  milk,  thereby  giving  the  consumer  due  notice 
of  any  undue  age. 

Commercial  pasteurization,  however,  is  not  carried  on  as  a 
health  measure,  but  purely  for  business  reasons.  It  is  for  the 
interest  of  the  large  milk  dealer  to  first  preserve  the  large 
volume  of  milk  he  has  on  hand  which  he  may  desire  to  hold  for 
a  day  or  two  before  selling,  and  second,  to  distribute  a  safe 
milk  in  order  to  avoid  possible  damage  suits  owing  to  possible 
epidemics  of  disease  among  his  customers.  The  latter  is 
avoided  by  the  pasteurization  of  the  milk.     Undoubtedly,  old 


108 


milk  and  milk  high  in  bacteria  are  pasteurized  commercially, 
and  no  doubt  much  pasteurized  milk  is  reinfected  with  bacteria. 


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The  chart  shows  the  influence  of  commercial  pasteurization 
upon  the  bacterial  content  of  milk,  the  statistics  being  obtained 
from  the  records  of  the  New  York  City  Department  of  Health. 
Two  sections  of  the  chart  show  good  conditions  in  the  pasteuri- 


109 

zation  plants,  and  the  third  section  shows  poor  conditions 
caused  by  contamination  of  the  milk  after  pasteurization,  or 
high  bacterial  content  before  pasteurization.  The  milk  in  these 
instances  was  degraded.  If  these  conditions  occur  in  super- 
vised supplies  they  must  be  very  frequent  in  unsupervised 
supplies. 

The    commercial    pasteurization    of    milk    should    be    under 
official  supervision  for  the  following  reasons:  — 

1.  To  prevent  the  pasteurization  of  milk  high  in  bacteria. 

2.  To  prevent' the  heating  of  milk  to  a  temperature  sufficient 
to  change  its  chemical  composition. 

3.  To  see  that  the  pasteurization  is  carried  out  in  such  a 
manner  that  the  pathogenic  bacteria  are  killed. 

4.  To  see  that  the  milk  is  not  reinfected  after  pasteurization. 


110 


PART  IV.  FACTS  OF  THE  PRESENT  OFFICIAL  SUPER- 
VISION OF  THE  MILK  SUPPLY  OF  THIS  COMMON- 
WEALTH. 


A.  PRESENT  STATUS  OF  OFFICIAL  SUPERVISION  OF  THE 
MASSACHUSETTS  MILK  SUPPLY  BY  FEDERAL,  STATE 
AND  LOCAL  AUTHORITIES. 

Local  Inspection. 

Local  milk  inspection  is  carried  on  under  the  provisions  of 
chapter  405  of  the  Acts  of  1909,  which  require  that  the  boards 
of  health  of  all  cities  shall,  and  the  boards  of  health  of  towns, 
or  the  selectmen  acting  as  such  boards,  may,  appoint  one  or 
more  inspectors  of  milk  for  their  respective  cities  and  towns. 
Each  inspector  shall  be  sworn  before  entering  upon  the  per- 
formance of  his  official  duties,  and  shall  publish  a  notice  of  his 
appointment  for  two  weeks  in  a  newspaper  published  in  his 
city  or  town,  or,  in  the  absence  of  such  newspaper,  shall  post 
the  notice  in  two  or  more  public  places  in  such  city  or  town. 
The  inspector  shall  keep  an  office,  and  shall  record  the  names 
and  places  of  business  of  all  persons  engaged  in  the  sale  of 
milk  within  his  city  or  town. 

The  boards  of  health  may  appoint  a  collector  of  milk.  The 
inspectors  or  collectors  may  enter  all  places  in  which  milk  is 
stored,  and  all  carriages  used  for  the  conveyance  of  milk,  and 
may  take  samples  for  analysis.  The  inspector  of  milk  shall 
license  the  persons  engaged  in  the  sale  of  milk,  except  pro- 
ducers selling  milk  to  other  than  consumers  or  less  than  20 
quarts  per  day  to  consumers. 

The  statutes  prohibit  the  sale  of  milk  containing  added  water 
or  any  foreign  substance,  or  as  pure  milk,  milk  from  which  the 
cream  or  any  portion  thereof  has  been  removed.  Skimmed 
milk  may  be  sold  if  labeled  as  such  in  uncondensed  Gothic  type 
not  less  than  1  inch  in  length.  The  statute  also  prohibits  the 
sale  of  milk  containing  less  than  12.15  per  cent,  total  solids, 
or  less  than  3.35  per  cent.  fat.  There  is  a  special  provision 
allowing  a  producer  of  milk  to  sell  milk  below  the  standard 


Ill 

until  twenty  days  after  he  has  received  written  notice  from 
the  inspector  that  his  milk  is  below  the  standard,  both  in 
solids  and  fat.  The  effect  of  this  statute  is  to  permit  the  pro- 
ducer to  sell  milk  with  total  solids  as  low  as  11.70  per  cent., 
because  such  milk  will  invariably  contain  at  least  3.35  per  cent, 
fat.  This  milk  cannot  be  sold  by  any  person  except  the  pro- 
ducer. 

Chapter  744  of  the  Acts  of  1914  provides  that  it  is  unlawful 
for  any  person  engaged  in  the  milk  business  to  sell  or  deliver 
any  milk  without  first  obtaining  a  permit  from  the  board  of 
health  of  the  city  or  town  where  such  milk  is  to  be  sold.  This 
permit  is  to  be  issued  only  after  an  inspection,  satisfactory  to 
the  board,  of  the  premises  upon  which,  and  the  condition  under 
which,  the  milk  is  produced.  The  boards  of  health  are  also 
permitted  under  this  act  to  make  such  reasonable  rules  and 
regulations  as  they  may  think  suitable  for  protecting  the  pub- 
lic health.  The  duty  of  enforcing  this  portion  of  the  act  has 
been  placed  in  the  hands  of  inspectors  of  milk  appointed  for 
their  respective  cities  or  towns.  If  the  board  of  health  revokes 
a  permit  they  shall  immediately  send  notice  of  the  fact  to  the 
State  Department  of  Health,  and  the  State  Department  of 
Health  must  then  notify  the  boards  of  health  of  other  cities 
and  towns  where  this  milk  is  liable  to  be  sold,  and  any  dealer 
in  milk  who  is  liable  to  sell  it,  of  the  action  of  the  local  board 
of  health.  After  receiving  such  notice  from  the  State  Depart- 
ment of  Health  it  is  unlawful  for  any  dealer  to  sell  or  offer  for 
sale  the  milk  from  a  dairy  the  permit  of  which  has  been  re- 
voked. It  is  the  duty  of  the  State  Department  of  Health  to 
enforce  this  portion  of  this  law. 

A  careful  study  of  the  provisions  of  this  act  will  show  that 
if  carried  out  as  it  should  be  there  would  be  a  needless  dupli- 
cation of  inspection  on  the  part  of  many  of  our  cities  and 
towns.  There .  is  scarcely  a  city  or  town  of  any  size  in  this 
State  in  which  the  milk  dealers'  supply  is  sold  exclusively;  for 
example,  the  milk  sold  in  Boston  is  to  a  large  measure  sold 
also  in  Lynn,  Salem,  Peabody,  Saugus,  Melrose,  Stoneham, 
Medford,  Maiden,  Winchester,  Arlington,  Belmont,  Somerville, 
Revere,  Chelsea,  Cambridge,  Watertown,  Waltham,  Newton, 
Brookline,   Dedham,   Milton  and   Quincy.     The   milk   sold   in 


112 

Springfield  is  to  some  extent  sold  also  in  West  Springfield.  The 
milk  sold  in  Hopkinton,  Holliston  and  Hopedale  is  also  sold  in 
Milford.  Milk  sold  in  Framingham  is  also  sold  in  Natick,  Wel- 
lesley  and  Sherborn.  Nearly  the  entire  milk  supply  of  Methuen 
is  from  the  same  source  which  supplies  the  city  of  Lawrence, 
and  milk  dealers  supplying  Dracut,  Chelmsford  and  Tewksbury 
also  deliver  milk  in  Lowell.  Similar  conditions  exist  in  other 
portions  of  the  State,  although  not  to  such  an  extent  as  in  the 
vicinity  of  Boston.  If  this  law  was  enforced  as  the  statute 
contemplates,  each  farmer  supplying  milk  to  these  various  milk# 
dealers  would  be  subjected  to  inspection  by  the  representatives 
of  the  boards  of  health  of  from  6  to  15  different  cities  or  towns,1 
and  in  many  cases,  even  with  the  little  enforcement  this  law 
has  had,  producers  have  been  visited  by  at  least  three  different 
inspectors  and  have  been  asked  to  comply  with  three  different 
sets  of  rules  and  regulations.  Even  if  the  representatives  of 
three  or  four  different  cities  or  towns  did  not  visit  the  same 
dairies,  the  provisions  of  this  act  require  them  to  make  in- 
spections in  the  same  territory.  For  example,  the  milk  from 
dairies  situated  within  1  mile  of  each  other  in  the  Connecticut 
valley  goes  in  some  instances  to  Greenfield,  in  others,  to  North- 
ampton or  to  Springfield;  and  similarly  in  Cheshire  the  farmers 
are  selling  in  some  instances  to  North  Adams,  and  in  others  to 
Pittsfield,  making  it  necessary  for  inspectors  of  North  Adams 
and  Pittsfield  to  visit  the  town  of  Cheshire  and  examine  dairies 
in  that  town  in  order  to  comply  with  the  provisions  of  this 
act.  Inasmuch  as  the  provisions  of  this  act  have  been  carried 
out  by  but  few  localities,  the  needless  duplication  of  inspection 
with  its  attending  difficulties  has  been  limited. 

State  Inspection. 

State  Department  of  Health. 

The  State  Department  of  Health  is  authorized  by  statute  to 
expend  annually  a  sum  not  exceeding  $17,500  for  the  enforce- 
ment of  the  laws  relative  to  the  adulteration  of  food  and  drugs, 
three-fifths  of  which  sum,  or  $10,400,  shall  be  spent  for  the 
enforcement  of  the  laws  relative  to  the  adulteration  of  milk 
and  milk  products.     Under  the  provisions  of  this  act  the  State 

1  Unless  local  boards  of  health  made  the  employees  of  other  boards  their  agents  for  dairy  inspec- 
tion. 


113 


Department  of  Health  collects  and  examines  milk,  butter, 
cheese,  condensed  milk,  cream  and  ice  cream.  If  any  viola- 
tions of  the  law  are  discovered  they  are  carefully  investigated, 
and,  if  conditions  warrant,  prosecutions  are  made  or  further 
investigations  started,  with  a  view  to  prosecuting  the  respon- 
sible offender. 

The  following  list  shows  the  number  of  samples  collected, 
examined  and  prosecuted  during  the  past  eight  years  by  the 
State  Board  of  Health. 


Samples  collected  and  examined. 

Prosecutions. 

Yeae. 

1 

n 

6 
o 

IS 

O 

o 

a 

a 
o 
O 

s 

OS 
9 
H 
O 

a 

03 
9 
u 
O 
o 
a 

o 

a 

3 

o 
u 

Ph 

1 

"3 

O 

1907, 
1908, 
1909, 
1910, 
1911, 
1912, 
1913, 
1914, 

2,992 
3,934 
4,611 
5,396 
4,690 
4,900 
6,702 
6,008 

87 
54 
68 
102 
30 
33 
58 
27 

15 
22 
22 
15 
9 
6 

3 

19 
38 
26 
23 
28 
27 
8 
44 

26 
170 
171 
104 
166 
100 
209 
284 

2 

132 
206 

3,139 
4,218 
4,900 
5,640 
4,923 
5,066 
7,109 
6,572 

142 

214 

171 

106 

78 

64 

101 

52 

5 

5 
9 
13 
4 
1 
5 
6 

147 

219 

180 

119 

82 

65 

106 

58 

Tot 

als, 

39,233 

459 

92 

213 

1,230 

340 

41,567 

928 

48 

1,066 

The  State  Department  of  Health  has  no  power  to  make  rules 
and  regulations  relative  to  the  sanitary  conditions  of  dairies, 
but  dairy  inspections  have  been  made  under  the  general  pro- 
visions of  the  law  creating  the  State  Board  of  Health.  The 
number  of  dairies  inspected  is  given  in  the  following  table :  — 


Year. 


1907, 
1908, 
1909, 
1910, 
1911, 


Number 
of  Dairies 
inspected. 


2,714 
2,231 
1,771 
2,053 
2,069 


Year. 


1912,  . 

1913,  . 

1914,  . 
Total, 


Number 
of  Dairies 
inspected. 


1,451 
4,493 

2,222 


19,004 


114 


Dairy  Bureau. 

The  Dairy  Bureau  of  the  State  Department  of  Agriculture 
has  an  annual  appropriation  of  $8,000  for  inquiry  into  the 
methods  of  butter  and  cheese  making,  and  for  the  enforcement 
of  the  laws  relating  to  the  sale  of  adulterated  milk  and  milk 
products.  The  Dairy  Bureau  maintains  a  general  agent  whose 
salary  is  provided  for  by  a  special  appropriation,  and  several 
other  agents  who  obtain  the  samples  and  make  the  necessary 
investigations.  The  chemical  work  is  all  done  by  private  chem- 
ists, being  paid  for  at  contract  prices  according  to  the  number 
of  samples  submitted.  The  Dairy  Bureau  does  but  very  little 
work  relating  to  the  adulteration  of  milk,  but  spends  the 
largest  amount  of  its  appropriation  enforcing  the  laws  relative 
to  the  sale  of  oleomargarine.  The  Dairy  Bureau  reports  that 
it  has  made  no  dairy  inspections  except  those  mad^  in  connec- 
tion with  the  clean  milk  and  other  contests. 

The  following  tables  show  the  number  of  samples  of  milk 
and  milk  products  examined  by  the  State  Dairy  Bureau  during 
the  past  eight  years,  and  the  number  of  prosecutions  for  the 
sale  of  adulterated  milk  and  milk  products. 

Samples  collected  and  examined. 


Year. 


Milk 

and 

Cream. 


Butter 
and 
Oleomar- 
garine. 


Cheese. 1 


Con- 
densed 
Milk,  i 


Ice 

Cream. 


Total 
Samples. 


1907,  . 

1908,  . 

1909,  . 

1910,  . 

1911,  . 

1912,  . 

1913,  . 

1914,  . 
Totals, 


192 
321 

90 
136 

35 
124 


1,182 
1,497 
1,779 
1,724 
1,282 
2,042 
3,458 
1,816 


1,043 


14,780 


1,374 
1,818 
1,869 
1,860 
1,317 
2,166 
3,552 
1,867 


15,823 


1  About  100  analyses  of  cheese  and  condensed  milk  are  included  with  the  butter  and  oleomar- 
garine figures. 


115 


Number  of  Prosecutions. 


Year. 


Milk. 

Cream. 

Butter. 

Oleomar- 
garine. 

19 

- 

72 

Ill 

13 

1 

51 

104 

5 

- 

33 

168 

4 

- 

77 

139 

2 

- 

60 

157 

6 

- 

88 

122 

2 

5 

54 

88 

9 

- 

27 

93 

60 

6 

462 

982 

Total 
Prosecu- 
tions. 


1907,  . 

1908,  . 

1909,  . 

1910,  . 

1911,  . 

1912,  . 

1913,  . 

1914,  . 
Totals, 


202 
169 
206 
220 
219 
216 
149 
129 


1,510 


Department  of  Animal  Industry.1 

The  State  Department  of  Animal  Industry  has  charge  of  the 
examination  of  animals  with  respect  to  the  presence  of  dis- 
eased conditions.  The  appointment  of  local  inspectors  is  similar 
to  that  pursued  in  the  appointment  of  inspectors  of  slaughter- 
ing. Nominations  of  inspectors  of  animals  are  made  by  the 
boards  of  selectmen  of  each  city  and  town,  which  nominations 
must  be  approved  by  the  Commissioner  of  Animal  Industry 
before  the  inspector  is  appointed.  The  statute  provides,  under 
certain  conditions,  that  a  portion  of  the  salary  of  these  men 
may  be  paid  by  the  State.  Inspections  by  these  local  inspectors 
of  animals  usually  take  place  in  the  spring. 

If  upon  examination  of  the  animals  on  a  certain  premises  the 
inspector  has  reason  to  suspect  the  presence  of  any  contagious 
disease,  such  animal  or  animals  are  quarantined,  and  the  in- 
spector sends  duplicate  copies  of  such  quarantines  to  the  office 
of  the  Department  of  Animal  Industry.  A  copy  of  the  report 
is  left  with  the  owner  of  the  animal,  another  one  retained  by 
the  inspector,  and  the  full  record  sent  to  the  office  of  the  De- 
partment of  Animal  Industry.  At  the  time  a  copy  of  this 
record  is  left  with  the  owner  of  the  premises,  such  recommen- 
dations for  improved  conditions  as  may  be  necessary  in  the 
opinion  of  the  inspector  are  brought  to  the  attention  of  the 


1  The  following  r6sum6  of  the  present  status  of  animal  inspection  is  directly  compiled  from  a 
statement  submitted  by  Dr.  Lestor  H.  Howard,  Commissioner  of  Animal  Industry. 


116 

owner  by  that  inspector,  and  the  owner  is  requested  to  make 
such  improvements.  A  later  visit  is  made  by  the  local  in- 
spector, at  which  time,  if  conditions  are  found  to  be  decidedly 
improved,  the  report  submitted  to  the  Department  above  re- 
ferred to  credits  the  owner  with  the  conditions  found  on  the 
second  visit,  and  in  most  cases  it  is  found  that  the  owners 
carry  out  the  recommendations  made  by  the  inspectors. 

As  a  result,  many  of  the  cases  that  under  a  former  plan 
would  have  been  called  to  the  attention  of  the  District  Agents 
of  the  Department  of  Animal  Industry  are  satisfactorily  dis- 
posed of  locally,  but  if  not  so  disposed  of  the  District  Agent  is 
sent  to  the  premises,  the  supervision  of  the  Department  of 
Animal  Industry  is  directly  given,  and  frequent  visits  made 
until  the  conditions  are  satisfactory. 

All  cattle  over  six  months  of  age  coming  into  Massachusetts 
from  any  point  without  the  State,  if  not  intended  for  immedi- 
ate slaughter,  are,  according  to  law,  tuberculin  tested  by  an 
agent  of  the  Department  of  Animal  Industry,  unless  accom- 
panied by  a  certificate  of  test  made  by  a  man  approved  by 
the  officials  of  the  State  wherein  the  shipment  originates.  All 
animals  reacting  to  this  test  are  destroyed. 

Federal  Inspection. 

The  United  States  Department  of  Agriculture,  Bureau  of 
Chemistry,  has  supervision  over  the  interstate  shipment  of 
food  including  milk,  and  over  the  food  introduced  into  this 
country  from  foreign  countries.  The  Bureau  of  Chemistry  has, 
until  recently,  taken  little  action  upon  the  subject  of  milk. 
Some  years  ago  Dr.  Charles  Harrington,  then  Secretary  of  the 
Massachusetts  State  Board  of  Health,  endeavored  to  induce 
Dr.  Harvey  W.  Wiley,  then  Chief  of  Bureau  of  Chemistry, 
United  States  Department  of  Agriculture,  to  prevent  the  ship- 
ment into  this  State  of  milk  from  dirty  dairies  in  New  Hamp- 
shire, and  this  the  Department  of  Agriculture  refused  to  do. 
Two  years  ago  Mr.  Lythgoe  endeavored  to  have  the  Bureau  of 
Chemistry  prevent  the  shipment  of  adulterated  milk  from 
Rhode  Island  into  Fall  River.  This  the  Federal  authorities 
refused  to  do.  The  United  States  Department  of  Agriculture 
has  authority  to  absolutely  prohibit  the  importation  into  this 


117 

country  of  any  food  product  which  may  be  adulterated  or  mis- 
branded,  or  the  sale  of  which  may  be  prohibited  in  the  country 
of  its  production.  Under  the  provisions  of  this  act  the  Federal 
government  has  recently  had  an  inspector  investigating  the 
sanitary  condition  of  dairies  and  creameries  in  Quebec.  Action 
taken  by  the  Federal  government  under  this  section  of  the  law 
need  not  be  passed  upon  by  the  courts. 

The  Commissioner  of  Health  of  the  State  of  Massachusetts 
has  been  made  ex  officio  a  Federal  officer  for  the  enforcement 
of  the  United  States  law  relative  to  food  samples  shipped  for 
sale  into  this  State,  and  the  analyst  of  this  Department  has 
been  made  the  collaborating  chemist  of  the  United  States  De- 
partment of  Agriculture.  Under  the  provisions  of  these  ap- 
pointments the  State  Department  of  Health  of  Massachusetts 
is  able  to  exercise  some  control  over  the  interstate  shipment  of 
foods,  but  as  a  rule  the  Federal  law  is  difficult  of  application, 
and  when  adulterated  milk  from  near-by  cities  or  towns  in 
other  States  has  been  shipped  into  Massachusetts,  this  De- 
partment has  invariably  succeeded  in  finding  the  producer  of 
the  milk  in  the  State,  and  obtaining  samples  from  him  at  the 
time  of  delivery  to  the  purchaser.  The  interstate  shipments 
of  milk  can  best  be  controlled  through  the  agency  of  the  person 
buying  the  milk  and  selling  the  same  in  this  State. 

B.    PRESENT  STATUS  OF  LOCAL  MILK  INSPECTION. 

The  present  statutes  regarding  local  milk  inspection  were 
drawn  with  the  contemplation  that  local  inspection  should  in 
general  be  supreme.  This  is  particularly  true  with  reference 
to  the  influence  of  milk  upon  public  health.  Cities  and  towns 
have  power  to  grant  or  refuse  licenses  to  milk  dealers,  to  issue 
or  refuse  permits  to  milk  dealers  or  milk  producers,  and,  what 
is  of  more  importance,  have  power  to  make  rules  and  regula- 
tions for  the  violation  of  which,  or  a  refusal  to  comply  with 
which,  the  license  or  permit  may  be  rendered  void  by  the  author- 
ity by  which  it  was  issued. 

In  order  to  ascertain  to  what  extent  the  local  boards  of 
health  exercised  the  authority  the  State  had  imposed  upon 
them,  a  questionnaire  and  an  addressed  envelope  was  sent  to 
all  the  local  boards  of  health  asking  for  information  relative 


118 

to  the  character  and  amount  of  milk  inspection  done,  the  lo- 
calities where  the  dairies  supplying  milk  were  situated,  the 
number  of  dairies  from  which  the  town  obtained  its  milk,  and 
a  statement  of  any  infectious  diseases  occurring  in  the  city  or 
town  which  may  have  been  caused  by  milk.  The  analysis  of 
this  questionnaire  is  given  elsewhere. 

A  second  set  of  questions  and  a  stamped  envelope  was  sent 
two  months  later  to  those  boards  making  no  reply  to  the  first 
questions.  Four  months  later  a  letter  was  sent  to  those  boards 
from  whom  no  reply  was  received,  asking  whether  or  not  any 
milk  inspection  work  was  done,  and  the  name  of  the  person 
in  charge  of  the  work.  This  letter  brought  in  a  few  more  re- 
sponses, and  three  weeks  later  another  letter  was  sent  to  the 
balance  of  the  cities  and  towns  making  no  reply,  stating  that 
in  the  absence  of  a  reply  it  would  be  assumed  that  no  milk 
work  was  done.  Up  to  Dec.  1,  1915,  no  replies  had  been  re- 
ceived from  a  number  of  towns  with  an  aggregate  population 
of  about  3,500  people,  or  1  per  cent,  of  the  total  population. 

It  was  desired  to  obtain  more  exact  figures  relative  to  the 
work  done  by  local  boards  of  health,  and  as  this  would  have 
involved  a  larger  amount  of  clerical  work  than  the  Board  felt 
it  could  request  the  local  authorities  to  perform  for  us,  the  in- 
spectors and  analysts  of  the  Food  and  Drug  Division  were  sent 
to  different  milk  inspectors,  or  agents  of  local  boards  of  health, 
requesting  permission  to  copy  certain  figures  from  the  official 
records  of  their  respective  departments.  These  local  officials 
showed  every  courtesy  to  our  investigators,  and  gave  all  the 
information  that  they  possibly  could. 

A  form  was  filled  out  for  each  town  visited,  and  then  the 
investigator  copied  from  the  local  inspectors'  books  upon  other 
forms  the  name  and  address  of  each  licensed  milk  dealer,  the 
number  of  wagons,  whether  or  not  the  milk  was  pasteurized, 
the  amount  of  raw  milk  sold,  the  amount  of  pasteurized  milk 
sold,  the  name  and  address  of  the  producers  supplying  the 
dealer,  and  the  dates  and  scores  of  the  dairy  inspection  made 
during  1914  and  1915. 

A  card  index  of  these  various  producers  and  dealers  has  been 
made,  and  we  have  at  present  a  list  of  the  names  and  addresses 
of  the  licensed  milk  dealers  of  this  State,  and  the  producers 


119 

supplying  them  with  milk,  except  the  dealers  and  producers 
supplying  the  city  of  Boston.  A  perusal  of  the  cards  shows 
that  with  but  few  exceptions  there  is  practically  no  duplication 
of  inspection,  and  in  many  instances  no  inspection  whatsoever. 
In  completing  these  statistics  the  varied  character  of  the  work 
done  in  the  different  cities  and  towns  has  rendered  it  a  difficult 
task  to  set  forth  the  results  obtained  in  a  clear  and  concise 
manner. 

It  has  been  found  necessary,  in  order  to  make  a  proper  com- 
parison of  the  work  done,  to  divide  the  cities  and  towns  into 
sixteen  groups  according  to  the  character  of  their  inspection 
work.  In  most  instances  it  was  found  necessary  to  subdivide 
the  towns  in  a  group,  for  notwithstanding  the  fact  that  the 
character  of  the  work  performed  entitles  these  towns  to  a  posi- 
tion in  the  group,  the  amount  of  work  performed  was  very 
slight  in  many  instances. 

It  was  found  that  the  replies  to  the  questionnaire  were  in 
many  instances  misleading,  most  of  which  were  in  favor  of  the 
local  boards  making  the  reply.  In  one  instance,  however, 
where  the  local  board  stated  that  no  milk  inspection  work  was 
done,  one  of  our  inspectors  found  a  milk  inspector  in  the  town 
doing  good  work. 

The  fact  that  the  local  milk  inspector  had  no  records  of 
dairy  inspection  does  not  necessarily  imply  that  his  work  as 
regards  actual  inspection  of  the  dairies  is  faulty  or  inefficient. 
Some  of  the  inspectors  have  demonstrated  to  us  the  fact  that 
their  dairy  inspection  is  productive  of  excellent  results,  although 
they  make  no  dairy  scores  and  keep  no  records  of  inspection. 
Many  of  these  inspectors  do  not  have  the  clerical  help  neces- 
sary to  keep  records  in  proper  shape,  and  therefore  may  con- 
sider it  futile  to  make  any.  In  the  case  of  death  or  resignation 
of  an  inspector,  however,  the  department  in  which  he  was  em- 
ployed has  no  records  with  which  to  ascertain  the  amount  and 
character  of  work  performed  by  the  inspector. 

Using  the  1910  population  figures,  645,000  people,  or  19  per 
cent,  of  the  total  population,  received  no  protection  relative  to 
milk  from  their  local  authorities  according  to  their  own  state- 
ment; and  if  we  include  the  1  per  cent.  who.  have  not  responded 
to  numerous  letters  from  the  Department,  the  balance  of  80 


120 

per  cent.,  or  2,680,000,  received  some  protection  from  their 
local  authorities;  2,102,000,  or  63  per  cent,  of  the  total  popula- 
tion, are  protected  by  some  bacteriological  work  and  some  dairy 
inspection,  and  1,446,000,  or  43  per  cent,  of  the  total  popula- 
tion, are  adequately  protected.  The  city  of  Boston  represents 
670,000  people,  or  46  per  cent,  of  the  population,  so  protected. 
Excluding  Boston  from  these  figures  and  recompiling,  the  re- 
sults are  as  follows:  25  per  cent,  of  the  population  receive  no 
protection,  53  per  cent,  are  protected  to  some  extent  by  bac- 
teriological examinations  and  by  dairy  inspection,  and  only  28 
per  cent,  are  adequately  protected.  By  adequate  protection 
is  meant  frequent  and  careful  inspection  of  dairies  combined 
with  frequent,  reliable  and  thorough  bacteriological  examina- 
tions of  milk. 

Qualifications  of  Local  Milk  Inspectors. 

While  no  attempt  has  been  made  to  accurately  summarize 
the  qualifications  of  local  milk  inspectors,  contact  with  the  dif- 
ferent men  has  given  quite  an  insight  into  their  ability.  These 
men  range  from  those  of  the  highest  ability  to  those  of  very 
little  ability.  Some  of  them  are  physicians,  some  are  chemists, 
some  are  pharmacists,  some  are  veterinarians,  some  are  men 
familiar  with  the  production  and  sale  of  milk,  and  some  are 
laymen.  Many  of  these  men  are  qualified  only  to  grant  li- 
censes, others  with  more  ability  specialize  in  dairy  inspection, 
and  have  materially  improved  the  conditions  under  which  the 
local  milk  supply  is  produced  and  handled.  Others  add  chem- 
ical analyses  to  their  work,  and  still  others  do  bacteriological 
work,  and  in  general  this  work  is  performed  in  a  creditable 
manner. 

Some  without  the  necessary  qualifications  attempt  to  carry 
out  complex  analytical  operations,  and  in  some  cases  may  have 
instituted  prosecutions  upon  incorrect  analyses.  One  such  in- 
stance was  brought  to  the  attention  of  the  State  Department 
of  Health.  The  local  inspector  in  this  instance  asked  for  in- 
formation relative  to  the  determination  of  nitrogen  in  milk  by 
the  Kjeldahl  process,  upon  which  determination  he  had  based  a 
prosecution.  This  inspector  desired  to  inform  himself  concern- 
ing the  process  in  order  to  be  able  to  answer  any  questions 


121 

which  might  be  put  to  him  upon  cross-examination.  During 
the  course  of  the  conversation,  it  developed  that  the  inspector 
had  standardized  his  acid  solution  against  a  known  weight  of 
sodium  hydroxide,  which  is  never  sufficiently  pure  for  this  pur- 
pose. Under  these  circumstances  there  might  have  been  a  pos- 
sible error  as  high  as  20  per  cent,  in  the  determination.  The 
inspector  in  this  instance  was  given  a  correct  method  of  stand- 
ardization, and  found  that  the  error  was  not  sufficient  to  change 
his  conclusions  of  the  character  of  the  sample. 

In  many  instances  the  laymen  among  the  local  inspectors 
have  developed  unusual  skill  in  the  analysis  of  milk,  and  have 
become  efficient  and  valuable  public  servants  notwithstanding 
their  scientific  and  technical  limitations.  In  the  country  dis- 
tricts the  inspector  is  generally  a  farmer  with  the  viewpoint  of 
the  producer  who  is  selling  his  products.  In  the  city  the  in- 
spector is  generally  a  consumer  with  the  viewpoint  of  the  man 
who  is  buying  milk.  When  these  two  classes  of  inspectors  come 
in  contact  with  each  other  by  working  in  the  same  territory 
there  develops  a  material  difference  of  opinion.  An  example  of 
this  was  shown  in  the  reports  of  inspections  made  in  one  town 
received  from  two  such  inspectors.  The  local  man  had  in- 
spected all  the  dairies,  and  in  his  opinion  they  were  in  proper 
shape  to  produce  milk  for  sale  anywhere.  The  inspector  of  a 
city  many  miles  away  where  the  milk  was  sold  inspected  the 
same  dairies  and  excluded  the  milk  of  about  25  per  cent,  of 
them  on  account  of  dirty  premises  and  unsanitary  conditions 
of  production  and  handling. 

The  salaries  paid  to  these  local  inspectors  are,  on  the  whole, 
inconsistent  with  the  necessary  qualifications  for  the  positions. 
Communities  should  realize  that  unless  they  pay  the  price  they 
cannot  get  the  services  of  competent  men,  even  if  in  some  in- 
stances competent  men  are  serving  as  local  inspectors  of  milk 
without  adequate  compensation. 

C.    DISCUSSION     OF    PRESENT    SYSTEM     OF    DAIRY    IN- 
SPECTION AND  ITS  SANITARY  VALUE. 

The  system  of  dairy  inspection  carried  on  at  present  in  this 
country  is  that  outlined  by  the  United  States  or  some  similar 
dairy  score  card,  although  the  former  is  the  one  which  is  most 


122 

used  for  the  reason  of  uniformity  in  comparison.  This  score 
card  allows  a  total  of  40  per  cent,  for  equipment  and  a  total 
of  60  per  cent,  for  methods.  Under  methods  8  per  cent,  is 
allowed  for  cleanliness  of  the  cows,  6  per  cent,  for  cleanliness 
of  the  stable,  8  per  cent,  for  cleanliness  of  the  utensils,  9  per 
cent,  for  cleanliness  during  milking,  and  16  per  cent,  for  the 
cleanliness  and  care  in  handling  of  the  milk.  Under  equipment 
6  per  cent,  is  allowed  for  the  health  of  the  cattle,  6  per  cent, 
for  the  location  and  construction  of  the  stable,  11  per  cent,  for 
light  and  ventilation,  9  per  cent,  for  construction  and  character 
of  utensils,  and  6  per  cent,  for  the  milk  house.  It  is  a  well- 
known  fact  that  clean  milk  can  be  produced  in  dirty  stables, 
provided  that  the  milker  is  a  clean  man  and  cow  has  been 
thoroughly  cleaned  before  milking,  but  under  ordinary  circum- 
stances milk  obtained  from  dirty  cattle  housed  in  dirty  stables 
is  liable  to  be  dirty  milk.  This  score  card  has  been  severely 
criticized  on  the  grounds  that  too  much  stress  is  laid  upon 
equipment  and  too  little  on  methods. 

A  questionnaire  was  sent  to  the  various  food  commissioners 
of  the  different  States  early  in  the  present  year  asking,  among 
other  questions,  whether  or  not  the  United  States  score  card 
was  of  any  practical  value  in  improving  dairy  conditions,  and 
what  changes  it  would  be  advisable  to  make  in  order  to  im- 
prove the  card.  Twenty-four  replies  were  received,  all  answer- 
ing the  first  portion  of  the  question  in  the  affirmative.  To 
the  second  portion  of  the  question  three  persons  suggested 
that  no  change  need  be  made,  but  11  others  suggested  changes, 
the  majority  of  which  were  to  the  effect  that  more  value  should 
be  given  to  methods  and  less  to  equipment.  The  character  of 
the  replies  were  very  characteristic  of  the  personnel  of  the 
various  departments.  For  example,  replies  from  health  boards 
only  stated  that  more  stress  should  be  placed  upon  cleanli- 
ness of  attendants,  health  of  cattle  and  medical  inspection  of 
attendants.  One,  a  director  and  chemist  of  an  experiment  sta- 
tion, replied  that  the  dairy  inspections  should  be  supplemented 
by  chemical  and  bacteriological  examinations  of  the  milk  and 
the  water. 

It  is  evident  by  the  replies  received  from  these  various  food 
commissioners  that  the  score  card  has  in  their  opinion  resulted 


123 

in  improved  dairy  conditions.  It  is  undeniably  true  that  if 
dairy  conditions  are  improved  dairy  products  must  of  necessity 
be  improved. 

Because  of  the  facts  that  an  exceptionally  clean  man  can 
produce  clean  milk  in  a  dirty  stable,  and  a  dirty  man  cannot 
produce  clean  milk  even  in  a  clean  stable,  certain  opponents  of 
inspection  of  dairies  or  of  other  forms  of  inspection  directed 
towards  farmers  seem  to  advocate  the  theory  that  the  proper 
way  to  produce  good,  clean  milk  is  to  have  dirty  stables  as  the 
first  requisite.  The  consumer,  however,  is  now  demanding  that 
the  factories  in  which  his  food  is  prepared,  warehouses  in  which 
it  is  kept,  and  the  stores  in  which  it  is  sold,  shall  be  clean. 
The  consumer  is  now  demanding  that  the  dairies  from  which 
his  milk  is  produced  shall  be  clean,  but  if  he  is  educated  to  the 
belief  that  producers  of  milk  need  not  keep  their  premises 
clean,  the  consumer  is  liable  to  abstain  from  the  use  of  milk, 
and  the  dairyman  loses  his  market. 

The  score  card,  however,  is  of  the  highest  educational  value 
to  the  farmer  by  pointing  out  the  measures  for  producing  clean 
milk  upon  old  premises.  If  a  dairy  farm  scores  very  low,  and 
the  farmer  desires  to  produce  a  better  article,  or  if  he  is  paid 
a  higher  price  for  a  better  article,  he  can  easily  improve  the 
score,  and  consequently  the  character  of  the  milk,  by  improv- 
ing the  methods  and  to  a  slight  extent  the  equipment. 

The  purchase  of  a  small-top  milk  pail  increases  the  score  by  5 
per  cent.,  washing  and  wiping  the  udders  before  milking  increases 
this  portion  of  the  score  to  6  per  cent.,  removing  the  milk  im- 
mediately from  the  stable  without  pouring  from  the  pail  adds 
2  per*  cent.,  cooling  immediately  after  milking  adds  2  per  cent, 
more,  and  cooling,  storing  and  transporting  below  50°  F.  adds 
10  per  cent,  to  the  score.  This  procedure  increases  the  total 
score  by  25  per  cent.,  and  if  the  stable  was  dirty  and  the  cows 
were  not  tuberculin  tested  the  dairyman  by  remedying  the  de- 
fects may  add  11  per  cent,  more  to  the  score,  and  by  building 
and  equipping  a  milk  room  and  keeping  it  clean  may  add  5 
per  cent,  more  to  the  score.  Thus  it  is  apparent  that  if  this 
portion  of  the  score  card  is  lived  up  to  both  the  quality  of  the 
milk  and  the  score  of  the  dairy  will  be  improved. 

In  order  to  see  whether  or  not  there  was  any  uniformity  in 


124 

the  dairy  scores  in  different  parts  of  the  country,  and  to  ascer- 
tain the  mathematical  difference  between  a  clean  and  a  dirty 
dairy,  the  scores  obtained  by  the  Milk  Board  upon  their  various 
trips  were  taken,  computations  made,  and  the  computations 
plotted  in  such  a  manner  that  the  various  scores  of  different 
portions  of  the  score  card  could  be  made  comparable  with  each 
other.  It  was  found  that  as  a  general  rule  the  dairies  scored 
relatively  higher  in  methods  than  they  did  in  equipment,  show- 
ing that  the  dairymen  appreciated  the  value  of  good  methods 
in  improving  the  product.  It  was  found,  however,  that  those 
dairies  supplying  milk  to  the  "contractors"  were  not  in  such 
good  condition  as  those  located  near  and  sending  milk  to  large 
cities.  The  scores  of  117  dairies  supplying  near-by  cities,  and 
the  scores  of  124  dairies  supplying  contractors,  were  separately 
combined  and  plotted,  the  resulting  plot  showing  that  the  con- 
tractor's dairies  were  somewhat  inferior  to  those  supplying  milk 
to  near-by  cities.  This  was  particularly  noticeable  in  that  por- 
tion of  the  score  relative  to  cleanliness  of  stable.  Thirty-five 
per  cent,  of  the  contractor's  dairies  scored  0  for  cleanliness  of 
the  stable,  and  15  per  cent,  scored  only  1.3  per  cent.  Of  the 
dairies  supplying  near-by  cities  none  scored  0  for  cleanliness 
of  stable,  and  only  8  per  cent,  scored  as  low  as  1.2  per  cent. 
Fifty-eight  per  cent,  of  the  dairies  supplying  near-by  cities 
scored  3.5  per  cent,  on  cleanliness  of  stable,  but  only  15  per 
cent,  of  the  contractor's  dairies  reached  this  score.  The  sys- 
tematic inspection  on  the  part  of  agents  of  local  boards  has 
had  an  influence  upon  those  dairies  located  near  their  re- 
spective cities  and  towns,  resulting  in  improved  conditions  at 
the  dairies.  These  conditions  are  due  to  the  fact  that  if  the 
farmer  is  paid  a  sufficient  price  to  make  it  profitable  to  pur- 
chase good  utensils  and  to  keep  his  stable  clean  he  will  do  so. 
The  farmers  supplying  milk  to  the  large  contractors  receive 
on  an  average  from  1.5  to  2  cents  less  per  quart  than  the 
farmer  selling  to  a  dealer  delivering  milk  in  a  near-by  city, 
and,  therefore,  cannot  afford  to  take  the  care  of  the  milk  and 
the  stable  that  the  dairyman  does  who  receives  more  money. 

Dairy  inspection  is  of  value  in  increasing  the  sanitary  quality 
of  milk  in  those  communities  where  it  is  rigidly  enforced,  and 
particularly  so  where  milk  is  sold  upon  its  sanitary  value.    It, 


125 

however,  should  be  almost  entirely  educational,  because  it  is 
the  milk  and  not  the  stable  which  is  consumed,  and,  therefore, 
the  inspection  and  the  improvement  of  the  milk  rather  than 
the  stable  should  be  the  prime  object.  There  is  no  doubt, 
however,  that  the  dairy  inspection  which  has  been  carried  on 
in  this  State  for  the  past  eight  years  has  resulted  in  an  im- 
provement of  dairy  conditions  and  of  the  milk  supply,  and  for 
this  reason  dairy  inspection  is  highly  desirable. 


126 


PART  V.    THE     RELATIONSHIP     BETWEEN     COW'S     MILK 
AND  THE  PUBLIC  HEALTH. 


A.    INTRODUCTION. 

The  enormously  diversified  individual  conditions  under  which 
cow's  milk  becomes  an  important  factor  in  human  health  or 
disease  may  be  reduced  to  three  great  groups:  — 

I.  The  relationship  between  the  use  of  cow's  milk,  or  milk 
products,  and  certain  infectious  diseases  of  man. 

II.  The  relationship  between  the  use  of  cow's  milk  as  a 
substitute  for  human  milk  and  the  death  rate  of  infants. 

III.  The  relationship  between  the  use  of  cow's  milk,  milk 
products  and  derivatives,  and  the  sustaining  of  that  balance 
of  the  processes  of  destruction  and  repair  within  the  human 
body  that  is  commonly  known  as  a  state  of  health,  or,  in  other 
words,  the  relationship  of  milk  to  human  nutrition,  or  the 
metabolism  of  milk. 

The  first  two  of  these  groups  have  one  common  ground  in  con- 
trast to  the  third.  They  represent  the  health-menacing  possi- 
bilities of  milk.  The  last  represents  the  health  and  life  sus- 
taining properties  of  milk  as  an  everyday  article  of  diet. 

Perhaps  the  most  unfortunate  thing  about  the  entire  litera- 
ture of  milk  —  about  the  present  agitation  relative  to  the  use 
of  cow's  milk  throughout  the  country  —  is  the  slight  amount 
of  emphasis  that  has  been  placed  on  the  value  of  milk  as  con- 
trasted to  the  dangers  of  milk  as  an  everyday  article  of  human  diet. 

Milk  as  an  incubator  of  infections,  the  limitations  of  the  cow 
as  a  substitute  for  the  human  mother,  the  connection  between 
dirty,  stale  and  decomposed  cow's  milk  and  the  summer  scourge 
of  the  innocents,  —  all  these  themes  have  been  worn  thread- 
bare, all  have  been  argued  to  the  point  of  exhaustion,  and  all 
more  or  less  conclusively  proved.  But  the  beneficent  role 
played  by  the  maligned  cow  even  under  the  most  adverse  con- 
ditions, in  stepping  into  the  breach  between  life  and  death 
when  mothers  fail,  has  received  all  too  scanty  emphasis. 


127 

It  may  even  be  seriously  questioned  whether  some  of  the 
well-intentioned  popular  agitation,  relative  to  the  disease-bear- 
ing possibilities  of  milk,  has  done  as  much  service  to  the  cause 
of  humanity,  by  pointing  out  the  existence  and  insisting  upon 
the  correcting  of  certain  very  real  and  serious  dangers,  as  they 
have  done  injury  to  that  cause  by  inducing  an  exaggerated 
fear  of  cow's  milk  as  it  is  produced  and  handled  at  present. 
This  fear,  in  turn,  has  led  to  attempts  to  substitute  for  cow's 
milk  other  materials  and  products  that  in  the  long  run  are 
vastly  more  inimical  to  human  health  in  general,  and  to  that 
portion  of  humanity  designated  as  infancy  in  particular. 

It  may  be  held  that  such  statements  as  the  foregoing  are 
damaging  to  the  "clean  and  safe  milk"  cause;  that  any  re- 
sponsible officials  making  such  statements  are  placing  them- 
selves in  the  position  of  apologists  for  the  cause  of  dirty  and 
disease-producing  milk.  Far  from  it.  Such  statements  simply 
indicate  that  the  other  side  of  the  problem  should  receive  its 
fair  consideration. 

In  the  United  States  during  the  past  thirty  years  it  has  be- 
come firmly  established  by  law  and  by  the  general  consensus 
of  public  opinion  that  the  business  of  producing  and  distribut- 
ing cow's  milk  has  such  extensive  and  direct  relations  to  the 
public  health  and  welfare  that  it  is  justifiable,  through  an  exer- 
cise of  that  police  power  which  resides  in  all  organized  govern- 
ment, to  interfere  with  the  commercial  processes  of  that  busi- 
ness to  an  extent  that  is  hardly  approached  in  any  other  line 
of  commercial  enterprise.  In  direct  proportion  to  the  growth 
of  such  sentiment  —  permitting,  even  demanding,  this  extraor- 
dinary interference  in  the  name  of  the  public  health  with  a 
legitimate  life-supporting  industry  —  it  becomes  more  and  more 
important  that  this  police  power  be  exercised  with  sanity,  dis- 
crimination and  fairness  to  all  concerned. 

Exaggeration  of  the  dangers  of  milk  as  they  are,  and  an  in- 
sistence upon  non-essential,  whimsical,  illogical  and  excessively 
costly  measures  of  alleged  protection  of  the  consumer's  milk  at 
the  present,  are  never  going  to  successfully  solve  the  problem 
of  safe,  clean  and  honest  milk  for  the  consumers  in  the  future. 

Perhaps  there  is  no  service  in  relation  to  the  milk  question 
that  is  needed  so  much  to-day  as  a  clear,  unbiased  statement 


128 

of  the  relative  evils  and  benefits  of  cow's  milk  to  the  human 
race  as  conditions  are  at  present. 

With  this  clearly  fixed,  with  the  excessive  overstatements  of 
present  dangers  and  the  moral  responsibility  of  the  deliberately 
dirty  or  careless  producer,  dealer  and  consumer  equally  clearly 
understood,  the  public,  who  is  the  final  arbiter  in  the  whole 
matter,  can  more  clearly  and  intelligently  fix  and  determine, 
through  its  representatives  and  duly  authorized  agents,  the 
degree  of  refinement  of  methods  that  it  considers  reasonable 
and  essential  for  its  own  best  interests,  and  the  price  that  it 
is  willing  to  pay  to  institute  such  minimum  standards  of  quality 
as  it  may  determine  upon  as  necessary  in  the  interests  of  the 
public  health  and  welfare. 

B.    MILK  AND  THE  COMMUNICABLE  DISEASES. 

The  more  important  diseases  of  man  that  milk  may  play  an 
important  role  in  transmitting  are  tuberculosis,  diphtheria,  scar- 
let fever,  typhoid  fever  and  septic  sore  throat. 

The  question  as  to  the  connection  between  milk  supply  and 
the  transmission  of  these  diseases  under  certain  circumstances 
is  no  longer  open  to  debate.  It  has  been  proved  beyond  reason- 
able doubt.  The  phases  of  the  problem  that  are  still  open  to 
discussion  are  (a)  how  great  a  relative  danger  in  the  transmis- 
sion of  these  diseases  is  milk  as  at  present  produced,  and  (6) 
what  are  the  most  reasonable,  efficient  and  economical  protec- 
tive measures  that  can  be  adopted  to  reduce  the  risk  of  such 
disease  transmission  through  milk  to  a  minimum? 

1.    Milk  and  Tuberculosis. 

Broadly  speaking,  among  the  various  human  diseases  that 
may  be  transmitted  by  infected  milk  tuberculosis  occupies  a 
unique  position.  This  is  due  to  the  fact  that  in  all  the  other 
important  milk-borne  diseases  the  infective  agency  is  human, 
and  comes  into  play  after  the  milk  has  been  drawn  from  the 
cow.  In  the  transmission  of  tuberculosis  it  is  possible  that 
subsequent  accidental  infection  of  milk  and  milk  products,  due 
to  human  tubercle  bacilli,  may  occur,  but  the  great  source  of 
danger  as  regards  tuberculosis  transmission  through  milk  is  the 
cow  herself. 


129 

So  much  confusion  still  exists  relative  to  the  connection  be- 
tween animal  and  human  tuberculosis,  due  to  the  great  con- 
troversy that  raged  in  regard  to  it  from  1901  to  1911,  that 
although  the  questions  at  issue  are  now  definitely  settled,  it  is 
perhaps  advisable  to  refer  to  them  briefly  in  order  to  make 
our  present  problem  perfectly  clear.  This  seems  the  more  de- 
sirable in  the  present  report  from  the  fact  that  your  Board 
has  found  several  among  the  milk  producers  of  this  Common- 
wealth who  are  under  the  serious  misapprehension  that  good 
scientific  authorities  still  deny  the  transmission  of  tuberculosis 
through  milk. 

Following  the  demonstration  of  the  tubercle  bacillus  in  1882 
by  Koch,  it  was  taken  for  granted  by  all  the  scientific  world 
that  the  two  diseases,  human  and  bovine,  were  identical,  and 
readily  and  mutually  transferable.  His  later  discovery  of  tuber- 
culin in  1890,  and  its  rapid  application  to  dairy  animals  for 
diagnostic  purposes,  quickly  demonstrated  that  tuberculosis  was 
more  prevalent  among  dairy  animals  than  had  been  previously 
suspected.  This  discovery  led  to  a  veritable  epidemic  of  sani- 
tary live-stock  legislation  directed  against  tuberculosis  in  cattle, 
which  spread  over  nearly  all  civilized  countries  during  the  90's. 
Prominent  among  such  laws  were  the  "tuberculin  testing  and 
slaughter  of  reactors"  laws  of  Massachusetts. 

Meanwhile,  in  1896,  Prof.  Theobald  Smith  demonstrated  that 
the  human  and  bovine  types  of  the  tubercle  bacillus  were  not 
identical,  but  possessed  quite  distinctive  differences  both  in 
appearance,  in  reactions  on  culture,  and  in  their  relative  viru- 
lence to  different  animals  when  injected  experimentally. 

In  1901  Koch  read  his  famous  paper  in  London,  in  which  he 
clearly  gave  the  impression  to  all  the  world  that  there  was  no 
relationship  whatever  between  human  and  bovine  tuberculosis. 
It  is  not  true,  as  has  been  often  alleged,  especially  by  some  who 
have  sought  to  minimize  or  deny  all  relationship  between  hu- 
man and  bovine  tuberculosis,  that  Koch  said  that  the  bovine 
bacillus  and  the  human  bacillus  were  two  different  germs.  He 
simply  said  they  were  two  types  of  the  same  species,  a  point 
Prof.  Theobald  Smith  had  long  before  made  clear.  But  he  did 
state  very  emphatically  his  opinion  that  the  two  had  little  in 
common.  To  quote  the  words  of  Professor  Welch  of  Johns 
Hopkins,   "Koch  certainly  left  the  impression  by  the  conclu- 


130 

sions  drawn  from  his  own  words  that  there  was  practically  no 
danger  whatever  of  infection  from  bovine  sources;  Koch  drew 
that  inference  without  basis  of  facts." 

The  controversy  that  this  opinion  of  Koch's  immediately 
aroused  and  the  great  practical  importance  of  the  subject  pre- 
cipitated one  of  the  most  intense  investigations  into  the  true 
nature  of  any  communicable  disease  that  has  ever  been  known. 
The  British  government  appointed  a  Royal  Commission  which 
worked  continuously  for  ten  years  upon  the  subject.  The  Ger- 
man government  appointed  a  similar. commission,  and  these  two 
commissions  and  other  investigators  the  world  over,  especially 
those  of  the  New  York  City  Health  Department  in  this  coun- 
try, carried  on  researches  for  years  into  every  conceivable  phase 
of  the  great  problem. 

These  researches  all  came  to  one  general  conclusion,  which 
can  perhaps  best  be  stated  in  the  words  of  the  British  Royal 
Commission  in  their  final  report  in  1911.  The  following  ques- 
tions were  submitted  to  them  for  investigation:  — 

Question  1.  —  As  to  whether  the  disease  in  animals  and  man  is  one  and 
the  same. 

Conclusion.  —  Whether  one  prefers  to  regard  bovine  tuberculosis  and 
the  cases  of  tuberculosis  in  man,  which  are  caused  by  the  human  type  of 
bacilli,  as  varieties  of  the  same  disease  or  as  independent  diseases,  there 
can  be  no  question  that  human  tuberculosis  is  in  part  identical  with 
bovine  tuberculosis.  Our  researches  have  proved  that  in  a  considerable 
proportion  of  cases  of  the  human  disease  the  lesions  contain,  and  are 
caused  by,  bacilli  which  in  every  respect  are  identical  with  the  bacilli 
which  are  the  cause  of  tuberculosis  in  cattle.  In  all  such  cases,  therefore, 
the  (human)  disease  is  the  same  disease  as  bovine  tuberculosis. 

Question  2.  —  Whether  animals  and  man  can  be  reciprocally  infected. 

Conclusion.  —  We  must  conclude  that  mammals  and  man  can  be 
reciprocally  infected  with  the  disease  tuberculosis. 

Question  S.  —  Under  what  conditions,  if  at  all,  the  transmission  of 
tuberculosis  from  animals  to  man  takes  place,  and  what  are  the  circum- 
stances favorable  or  unfavorable  to  such  transmission. 

Conclusion.  —  Whatever  may  be  the  animal  source  of  tuberculosis  in 
adolescents  and  in  adults,  there  can  be  no  doubt  that  a  considerable 
proportion  of  the  tuberculosis  affecting  children  is  of  bovine  origin. 

And  again:  — 

It  may  be  asked  in  what  way  are  children  .  .  .  most  likely  to  obtain 
a  large  and  fatally  infective  dose  of  tubercle  bacilli?  ...  To  this  question 


131 

there  can  be  but  one  answer,  namely,  that  ...  a  considerable  amount 
of  the  tuberculosis  of  childhood  is  to  be  ascribed  to  infection  with  bacilli 
of  the  bovine  type  transmitted  to  children  in  meals  consisting  largely  of  the 
milk  of  the  cow. 

The  fact  of  the  existence  of  bovine  tuberculosis  infection  in 
human  beings  once  demonstrated,  the  all-important  question 
from  the  standpoint  of  practical  safeguarding  of  the  milk  sup- 
ply of  any  nation,  State  or  community  is,  how  great  a  danger, 
how  great  a  menace  to  human  life  is  this  transmission  of  bovine 
tubercle  bacilli  to  man?  And  what  are  the  most  logical  steps 
to  be  taken  to  minimize  or  entirely  eradicate  this  danger? 

From  the  careful  and  extensive  investigations  of  Park  and 
Krumwiede,  of  the  New  York  City  Health  Department,  it 
would  appear  that  at  least  one-third  of  all  cases  of  tuberculosis 
in  children  under  five  years  of  age  are  due  to  bovine  bacilli, 
and  nearly  as  great  a  proportion  in  cases  occurring  in  children 
between  five  and  fifteen  years  of  age. 

It  would  also  appear  that  the  bovine  type  of  bacillus  is  prac- 
tically never  found  in  adult  pulmonary  tuberculosis  or  con- 
sumption, but  this  does  not  necessarily  mean  that  infection  in 
childhood  by  the  bovine  tubercle  bacillus  has  no  relation  to 
the  occurrence  of  adult  consumption. 

When  consumption  is  excluded,  the  percentage  of  adult  tuber- 
culosis due  to  the  bovine  tuberculosis  in  the  large  series  of 
cases  so  exhaustively  investigated  rises  to  7.3  per  cent.  Various 
leading  authorities,  American  and  foreign,  are  in  substantial 
agreement  that  at  least  5  to  7  per  cent,  of  tuberculosis  in  hu- 
man beings  is  definitely  and  directly  of  bovine  origin.  And 
the  possibility  of  the  true  percentage  being  still  higher  cannot 
be  denied. 

In  addition  to  these  well-demonstrated  dangers  to  the  human 
race  from  tuberculous  milk,  two  other  theories  have  been  ad- 
vanced and  have  received  very  serious  attention  from  the 
world's  best  authorities  on  tuberculosis. 

The  first  theory  is  based  on  the  fact  that  after  all,  the  dif- 
ferences between  the  human  and  the  bovine  tubercle  bacillus 
are  merely  differences  of  type  or  of  degree.  They  cannot  be 
considered  as  distinct,  fixed  species.  Or,  to  use  the  apt  illus- 
tration of  Professor  Ravenel,  the  differences  between  human 


132 

tubercle  bacilli  and  bovine  tubercle  bacilli  are  analogous  to  the 
differences  between  a  Jersey  cow  and  a  Holstein  cow,  rather 
than  to  the  differences  between  a  cow  and  a  horse. ,  With  this 
admitted,  it  is  entirely  conceivable  that  bovine  bacilli  might 
be  taken  into  the  body  in  childhood,  and  after  a  lapse  of  years, 
by  spontaneous  breeding  in  human  tissues,  finally  take  on  the 
essential  characteristics  of  the  human  bacillus  in  much  the  same 
manner  as  a  farmer  may  greatly  change  the  characteristics  of 
his  final  product  in  any  field  crop  by  seed  selection  extended 
over  a  period  of  years,  without  introducing  any  outside  seed. 
If  this  does  actually  occur,  if  bovine  bacilli,  taken  into  the 
child's  body  through  milk,  under  the  influence  of  a  human  en- 
vironment, in  the  course  of  many,  many  generations  of  germ 
life,  approach  the  human  bacillus  type,  and  finally  become 
manifest  as  active  tuberculosis  in  the  adult,  then,  the  bacilli 
recovered  showing  human  characteristics,  the  infection  would 
naturally  be  ascribed  to  human  origin  although  in  reality  bo- 
vine. There  are  some  facts  that  tend  to  support  this  view, 
but  the  majority  of  authorities  are  not  inclined  to  believe  in 
it,  although  no  one  can  yet  positively  deny  its  correctness. 

The  other  theory  has  received  much  more  favorable  consid- 
eration, and  it  is  perhaps  not  putting  it  too  strongly  to  say 
that  certain  of  its  originally  assumed  conditions  are  beginning 
to  be  quite  firmly  established  as  facts.  Without  going  into  de- 
tails that  would  be  entirely  out  of  place  here,  it  is  enough  to 
say  that  the  fundamental  concept  of  this*  view  is  simply  that 
certain  infections  with  bovine  tubercle  bacilli  in  early  child- 
hood, which  at  the  time  cause  very  slight  or  no  visible  consti- 
tutional symptoms,  may  be  an  important  factor  in  the  devel- 
opment of  tuberculosis  later  in  life  by  rendering  the  person 
less  resistant  to  heavy  doses  of  the  human  bacilli  than  he 
would  otherwise  have  been. 

Other  points  of  great  significance  in  the  relationship  of  milk 
to  tuberculosis  are:  how  many  of  our  dairy  cows  are  tuber- 
culous; which  ones  among  the  tuberculous  animals  are  dan- 
gerous to  the  consumer  of  raw  milk;  and  how  relatively 
frequent  is  the  occurrence  of  bovine  tubercle  bacilli  in  ordinary 
market  milk,  cream,  butter,  etc. 


133 

A  complete  discussion  of  the  first  point  would  take  us  too 
far  into  the  field  of  veterinary  medicine.  Suffice  it  to  say  that 
while  absolutely  reliable  figures  for  all  the  dairy  cattle  of  any 
nation  or  State  do  not  exist,  such  authorities  as  Chief  Melvin 
of  the  Federal  Bureau  of  Animal  Industry  and  Professor  Moore 
of  Cornell  concur  in  the  opinion  that  not  less  than  10  per  cent, 
of  the  dairy  cows  of  the  United  States  are  affected  with  bovine 
tuberculosis.  M'Fadyean,  an  eminent  British  authority,  esti- 
mates that  30  per  cent,  of  British  cows  are  tuberculous.  In 
Massachusetts  over  a  period  of  fifteen  years,  from  1893  to 
1908,  out  of  a  total  of  86,223  animals  tested,  11,853  reacted 
to  the  tuberculin  test  for  tuberculosis,  10,760  of  them  were 
slaughtered  and  10,688,  or  99.34  per  cent.,  were  found  definitely 
tuberculous  at  post-mortem  examination.  It  is  interesting  to 
note  that  although  comparatively  few  examinations  are  being 
made  at  present  in  this  State,  it  seems  to  be  quite  a  universal 
opinion  among  the  older  milk  producers  interviewed  that  bo- 
vine tuberculosis  is  relatively  much  less  frequent  among  the 
Massachusetts  dairy  cows  than  was  the  case  twenty  years  ago. 

These  figures  are  enough  to  show  the  great  extent  of  the 
disease  tuberculosis  among  dairy  cattle. 

The  evidence  is  now  complete  showing  that  tubercle  bacilli 
are  excreted  in  large  numbers  in  the  dung  of  tuberculous  cows, 
and  that  this  occurs  even  when  there  is  no  lesion  of  the  ani- 
mal's intestines. 

It  is  also  quite  universally  agreed  that  at  least  2  per  cent, 
of  tuberculous  cows  suffer  from  tuberculosis  of  the  udder.  In 
this  disease  prodigious  quantities  of  bovine  tubercle  bacilli  pass 
directly  into  the  milk  with  every  milking,  but  under  present 
conditions  it  is  more  than  likely  that  even  more  tubercle  bacilli 
in  the  aggregate  pass  into  the  milk  from  the  dried  dung  of  the 
tuberculous  animals. 

Two  or  three  other  points  bearing  upon  the  same  subject  are 
of  great  practical  significance. 

(a)  That  the  clinical  diagnosis  of  tuberculosis  in  cows  is  rec- 
ognized as  impracticable  in  all  except  the  well-marked  cases. 

(b)  That  extremely  small  amounts  of  milk  from  cows  suf- 
fering from  udder  tuberculosis  are  sufficient  to  produce  tuber- 


134 

culosis  experimentally  in  animals  when  administered  by  inocu- 
lation. 

(c)  That  tuberculosis  can  be  induced  with  Varying  degrees 
of  readiness  in  various  animals  by  feeding  tuberculous  milk 
(i.e.,  milk  from  cows  suffering  from  tuberculosis  of  the  udder), 
and,  what  is  more  significant,  in  none  of  the  considerable  series 
of  animals  so  tested  by  the  British  Royal  Commission  did  this 

*  occur  more  readily  than  in  the  anthropoid  apes,  their  relative 
susceptibility  being  much  higher  than  that  of  calves. 

(d)  That  samples  of  unselected  raw  market  milk  taken  at 
random  from  the  city  milk  supplies  of  many  European  and 
American  cities  have  been  proved  by  the  work  of  many  in- 
vestigators to  contain  virulent  bovine  tubercle  bacilli  in  from 
2  to  50  per  cent,  of  samples  taken,  with  an  average  of  between 
10  and  20  per  cent,  probably  predominating. 

Without  going  into  any  details,  it  is  obvious  that  there  are 
only  two  conceivable  general  lines  of  action  that  will  be  prac- 
ticable in  coping  with  the  problem  of  minimizing  or  eradicating 
the  danger  of  bovine  tuberculosis  to  the  human  race.  They 
are  either  the  practical  extermination  of  bovine  tuberculosis, 
or  such  universal  treatment  of  cow's  milk  as  would  render  it 
safe  and  inocuous  from  the  standpoint  of  transmitting  tuber- 
culosis, even  though  it  may  originally  have  contained  more  or 
less  tubercle  bacilli.  As  a  practical  procedure  it  is,  of  course, 
necessary  that  both  lines  of  action  be  followed. 

The  struggle  against  bovine  tuberculosis  among  dairy  herds 
is  a  subject  that  does  not  strictly  pertain  to  this  report,  inter- 
esting though  it  would  be  to  review  some  of  its  more  salient 
features.  It  must  be  admitted  that  up  to  the  present  time  the 
total  progress  in  this  line,  while  by  no  means  negligible,  cannot 
be  considered  as  sufficient  to  give  us  any  sound  basis  upon 
which  to  base  any  hope  of  eliminating  the  menace  of  bovine 
tuberculosis  by  this  means  in  the  near  future.  Certain  im- 
portant subsidiary  measures  should  never  be  neglected,  such 
as  careful  veterinary  inspection  of  herds  to  rule  out  tuber- 
culosis of  the  udder,  and  insistence  upon  such  standards  of 
dairy  cleanliness  in  general,  and  of  clean  methods  of  milk- 
ing in  particular,  as  will  guarantee  a  minimum  possibility  of 
tubercle-infected  dung  finding  its  way  into  the  milk.    But  the 


135 

surest,  most  economical  and  quickest  method  that  has  ever  yet 
been  devised  to  bring  about  the  end  in  view,  namely,  the  per- 
fect safeguarding  of  the  milk  supply  as  regards  bovine  tuber- 
culosis, is  through  the  resort  to  the  process  of  pasteurization. 
Pasteurization  in  its  relation  to  communicable  diseases  in  gen- 
eral will  be  considered  later.  It  is  sufficient  to  make  the  defi- 
nite, emphatic  statement  here  that  pasteurization  properly  per- 
formed will  undoubtedly  remove  all  danger  of  transmission  of 
tuberculosis  through  milk. 

2.    Methods  of  Infection  of  Milk  by  Diphtheria,  Scarlet  Fever, 
Septic  Sore  Throat  and  Typhoid  Fever. 

That  milk  is  a  most  favorable  medium  for  the  growth  of 
specific  organisms  of  certain  infectious  diseases  of  man  has  been 
demonstrated  by  Eyre.  He  found  that  typhoid  bacilli  were 
multiplied  in  healthy  cow's  milk  6,000  times  in  twenty-four 
hours,  while  diphtheria  bacilli  increased  more  than  1,000  times 
during  the  same  period.  However,  this  experimental  work  was 
done  upon  milk  obtained  under  sterile  conditions.  Your  Board 
has  not  found  any  reliable  data  upon  the  amount  or  rate  of 
increase  of  pathogenic  bacteria  in  unsterilized  milk  under  or- 
dinary conditions  of  temperature.  It  can  be  readily  seen  that 
in  the  presence  of  the  many  non-virulent  types  of  bacilli  found 
practically  universally  in  raw  milk,  the  question  of  determining 
just  how  rapidly  growth  of  disease-producing  bacteria  occurs  is 
practically  insoluble.  The  presence  of  acid-forming  bacteria  in 
milk  checks  their  growth,  but  cannot  be  relied  upon  to  kill  any 
contained  typhoid  bacilli  (Savage).  Their  viability  has  been 
determined  by  Hesse  and  Field,  whd  found  the  typhoid  bacilli 
to  survive  as  long  as  four  months  in  sterilized  milk.  It  is, 
therefore,  readily  seen  how  small  particles  of  infection  conveyed 
to  milk  may  infect  large  supplies  in  the  mixing  and  handling, 
and  in  turn  may  infect  susceptible  individuals  who  drink  the 
raw  milk.  Of  the  infection  of  milk  from  human  sources  there 
is  now  abundant  evidence.  Rosenau  writes  that  "the  more 
serious  infections  in  milk  come  from  human  origin."  It  may 
be  conveyed  directly  or  indirectly.  Typhoid  infection  may  be 
conveyed  directly  to  the  milk  by  the  person  taking  care  of  the 
patient,  whose  other  duties,  after  taking  care  of  the  patient 


136 

and  handling  soiled  bed  linen,  include  the  care  and  handling 
of  milk.  A  source  determined  in  recent  years  to  be  quite  com- 
mon is  the  carrier  or  person  who  shows  no  symptoms  of  the 
disease,  but  whose  excreta  contain  the  infection.  These  find- 
ings have  been  duplicated  so  many  times  now  as  to  become 
commonplace.  Twice  in  this  State  during  the  present  year  has 
the  same  point  been  completely  determined,  —  in  one  instance 
in  a  carrier  who  had  the  disease  five  years  previous,  and  in  the 
other  in  a  carrier  who  had  the  disease  at  least  thirty-five  years 
previous.  Lumsden  and  Woodward  cite  an  instance  of  a  woman 
milker  on  a  dairy  who  had  typhoid  fever  eighteen  years  before 
the  outbreak  which  was  attributed  to  her.  Typhoid  bacilli 
were  found  in  large  numbers  in  her  feces.  No  other  source 
could  be  found  to  account  for  the  infection  in  the  milk. 

Still  another  source  of  direct  infection  comes  from  the  con- 
valescent whose  feces  and  urine  still  contain  the  bacilli,  and 
who  is  not  sufficiently  isolated  from  the  milkers  or  others  han- 
dling milk. 

Indirectly,  typhoid  infection  may  get  into  the  milk  through 
the  medium  of  sewage-polluted  water  used  for  washing  the 
milk  utensils,  or  by  fraudulently  adulterating  the  milk  with 
specifically  polluted  water. 

Diphtheria  infection  of  milk  most  usually  occurs  directly 
from  persons  engaged  in  milk  production  or  in  the  handling 
of  milk  while  suffering  with  a  mild  or  unrecognized  form  of 
the  disease;  or  by  persons  similarly  employed  who  show  no 
symptoms  of  the  disease,  but  who  carry  the  bacteria  in  the 
nose  and  throat;  or  by  such  persons  coming  in  contact  with 
milkers  or  others  handling  milk.  Bacteriology  now  plays  an 
important  role  in  the  discovery  of  milk-borne  epidemics.  Out- 
breaks have  occurred  where  persons  employed  as  milkers,  upon 
bacteriological  examinations  have  shown  the  presence  of  viru- 
lent diphtheria  bacilli  in  their  throats.  Klein,  through  experi- 
ments, has  tried  to  show  the  possibility  of  bovine  diphtheria, 
but  practically  all  the  present-day  authorities  hold  that  there 
is  no  evidence  that  the  diphtheria  bacillus  is  ever  of  bovine 
origin.  That  teat  ulcers  may  be  secondarily  infected  with  diph- 
theria bacillus  by  milkers  has  been  demonstrated.  Dean  and 
Todd,  in  1902  described  a  small  outbreak  in  which  diphtheria 
bacilli  were  isolated  from  the  teat  lesions  and  from  the  milk. 


137 

Through  human  channels  the  virus  of  scarlet  fever  may  be 
introduced  into  the  milk  in  similar  ways  to  that  of  diphtheria. 
The  usual  way  is  from  an  unrecognized  case  coming  in  contact 
directly  or  indirectly  with  the  milk  supply.  Harrington  records 
an  extensive  outbreak  as  being  caused  by  a  man  employed  to 
taste  milk,  who  used  the  same  spoon  in  sampling  each  lot  of 
milk.  The  daugnter  of  this  man  was  found  to  be  desquamating, 
and  he  himself  showed  symptoms  of  the  disease.  The  possi- 
bility of  bovine  infection  with  scarlet  fever  has  been  studied 
by  Klein  in  connection  with  the  Hendon  outbreak  of  1885,  and 
while  his  views  were  favorable,  they  have  been  strongly  op- 
posed by  other  observers.  Rosenau  states  that  "Cows  do  not 
have  typhoid  fever,  diphtheria  or  scarlet  fever." 

As  to  the  possibility  of  bovine  streptococcus  infection  being 
the  cause  of  septic  conditions  in  the  throat  of  man,  Theobald 
Smith  states,  "There  is  at  present  no  satisfactory  evidence  that 
bovine  streptococci  associated  with  mastitis  or  garget  are  the 
agents  of  tonsillitis  in  man."  From  the  results  of  certain  ex- 
periments conducted  by  Savage,  it  is  suggested  that  under 
ordinary  conditions  bovine  streptococcus  mastitis  is  not  a  cause 
of  human  disease.  Rosenau  says,  "It  is  assumed  that  the  in- 
fection usually  gets  into  the  milk  from  human  sources,  although 
it  is  suspected  that  streptococci  eliminated  by  diseased  udders 
may  be  responsible  for  some  outbreaks."  Milk-borne  outbreaks 
of  septic  sore  throat  in  this  country,  after  careful  investiga- 
tion, have  failed  to  disclose  any  disease  of  cows  sufficient  to 
account  for  the  infection. 

3.  Communicable  Diseases  of  Minor  Significance  or  Relative 
Infrequency,  in  which  Milk  is  concerned  as  an  Agent  of 
Transmission. 

Although  there  are  several  other  communicable  diseases 
which  are  transmitted  through  the  medium  of  infected  milk, 
tuberculosis,  diphtheria,  scarlet  fever,  typhoid  fever  and  septic 
sore  throat  comprise  all  the  communicable  diseases  of  man,  in 
whose  transmission  cow's  milk  ever  becomes  an  important  fac- 
tor, that  are  of  any  practical  importance  in  the  State  of 
Massachusetts. 


138 


4.  The  Evidence  available  as  to  the  Relative  Importance  of 
Milk  as  a  Means  of  Transmission  of  Communicable  Diseases, 
as  compared  with  Other  Means  of  Transmission. 

Incidental  reference  has  already  been  made  to  this  part  of 
the  public  health  problem  of  milk  in  considering  the  individual 
diseases,  but  certain  generalizations  on  this  point  are  needed 
to  make  the  exact  status  of  the  problem  clear. 

One  point,  and  only  one  point,  can  be  considered  as  settled, 
viz.,  that  cow's  milk  from  either  animal  {e.g.  in  tuberculosis) 
or  human  {e.g.  in  typhoid)  sources  may,  and  more  or  less  fre- 
quently does,  become  infected,  and  thereby  under  certain  con- 
ditions subsequently  becomes  the  causative  factor  in  the  trans- 
mission of  such  diseases  to  man.  But  the  all-important  ques- 
tion in  this  connection  at  once  arises  as  to  just  how  great  a  source 
of  danger  milk  is  in  this  respect  under  our  present  conditions. 

It  is  not  very  flattering  to  the  present  condition  of  American 
epidemiology  to  be  obliged  to  report  that  it  is  impossible  to 
give  even  a  roughly  approximate  estimate  upon  this  extremely 
important  and  practical  point. 

One  point  that  needs  to  be  firmly  kept  in  mind  is  that  prac- 
tically all  of  our  present  information,  with  one  or  two  notable 
exceptions,  relates  to  milk  as  a  disease  factor  under  epidemic 
conditions  only.  No  State  in  the  United  States  makes  a  suf- 
ficiently careful  study  of  its  communicable  diseases  to  give  a 
reliable  basis  upon  which  to  form  any  opinion  in  regard  to  the 
relative  importance  of  infected  milk  in  the  occurrence  of  the 
so-called  sporadic  or  isolated  or  endemic  cases  of  typhoid,  diph- 
theria or  scarlet  fever. 

Tuberculosis  is  a  disease  that  is  never  epidemic;  in  all  cir- 
cumstances it  must  be  regarded  as  of  sporadic  or  endemic 
origin.  The  reasons  why  as  yet  it  is  impossible  to  state  with 
any  degree  of  certainty  the  possible  maximum  effect  of  tubercle 
bacilli  infected  milk  upon  the  prevalence  of  human  tuberculosis 
have  already  been  explained.  But  all  of  the  other  serious  com- 
municable diseases  of  man  that,  so  far  as  we  know,  are  in  part 
spread  through  infected  milk  occur  in  both  epidemic  and  en- 
demic or  sporadic  form. 

Looking  at  the  problem  of  the  relation  of  milk  to  the  public 
health  in  its  entirety,  in  order  to  give  it  its  proper  weight  and 


139 

proportion  compared  to  other  health  problems,  it  is  highly  de- 
sirable to  know  just  how  great  a  factor  in  both  the  epidemic 
and  endemic  occurrence  of  typhoid,  scarlet  fever,  diphtheria 
and  septic  sore  throat  infected  milk  actually  is.  Obviously,  if 
it  were  possible  to  prove,  or  even  if  it  were  possible  to  deduce 
strong  presumptive  evidence  to  indicate  that  milk  infection  is 
a  75  per  cent,  factor  in  the  total  incidence  of  these  diseases, 
then  our  obligations  to  the  public  health  would  justify,  even 
demand,  the  advocating  of  prophylactic  measures  much  more 
drastic  and  expensive  than  would  be  indicated  if,  on  the  con- 
trary, infected  milk  could  only  be  demonstrated  to  be  respon- 
sible for  1  or  2  per  cent,  of  the  total  incidence  of  these  same 
diseases. 

In  the  one  instance  almost  any  expense  and  stringency  of 
sanitary  regulations  could  be  justified,  for  by  their  vigorous 
application  there  would  be  every  opportunity  to  rapidly  de- 
crease the  prevalence  of  these  diseases  to  such  an  extent  as  to 
render  their  total  suppression  a  reasonable  prospect  in  the  im- 
mediate future. 

In  the  other  instance  there  would  be  no  such  justification 
from  a  public  health  standpoint.  To  make  the  point  clear,  let 
it  be  assumed  that  it  had  been  proved  that  only  1  per  cent, 
each  of  the  total  number  of  cases  of  typhoid,  diphtheria  and 
scarlet  fever  were  due  to  infected  milk;  obviously,  under  such 
conditions,  the  expenditure  of  enough  money  and  energy  to 
totally  eradicate  milk  as  a  source  of  infection,  while  a  desir- 
able object  in  itself,  would  have  a  scarcely  appreciable  effect 
upon  the  general  typhoid,  diphtheria  and  scarlet  fever  prob- 
lem, and  it  is  highly  probable  that  the  same  amount  of  money 
and  energy  directed  against  other  angles  of  the  typhoid,  diph- 
theria or  scarlet  fever  problem  might  bring  incomparably 
greater  results  in  decreasing  their  prevalence. 

Because  of  the  great  practical  importance  of  these  factors 
your  Board  has  endeavored  diligently  to  ascertain  what,  if  any, 
reliable  data  could  be  obtained  upon  this  point,  both  within 
the  Commonwealth  and  elsewhere.  The  total  information  ob- 
tained is  exceedingly  incomplete,  but  perhaps  throws  some  light 
on  the  problem. 


140 


(1)  Evidence  as  to  the  Relative  Importance  of  Milk 
Infection  in  the  Transmission  of  Certain  Communi- 
cable Diseases  of  Man  based  on  their  Occurrence 
in  Epidemics. 

It  has  become  quite  the  fashion  of  late  years  among  writers 
in  discussing  milk  to  remark  that  the  importance  of  milk  in 
connection  with  typhoid,  scarlet  fever,  etc.,  has  been  until  very 
recently  underestimated.  Your  Board  feels  that  it  is  perhaps 
not  out  of  place  to  suggest  the  possibility  that  in  the  past  four 
or  five  years  at  least  this  tendency  has  been  reversed,  and  that 
to-day  there  is  a  strong  tendency  to  overestimate  the  quanti- 
tative relationship  of  milk  to  the  prevalence  of  these  epidemic 
diseases. 

An  interesting  example  of  this  probably  unconscious  tendency 
is  the  following:  In  1907  it  was  reported  that  out  of  a  total  of 
18  outbreaks  of  typhoid  fever  investigated  during  the  two  years 
immediately  preceding  by  the  Massachusetts  State  Board  of 
Health,  14,  or  77  per  cent.,  were  due  to  infected  milk.  In  the 
years  1910-14  (inclusive)  the  same  Board  investigated  a  total 
of  86  outbreaks  of  typhoid,  which  were  all  that  came  to  the 
attention  of  the  Board,  and  presumably  represent  practically 
100  per  cent,  of  all  epidemics  or  outbreaks  of  any  consequence 
occurring  in  the  State,  but  found  only  31,  or  36.4  per  cent.,  due 
to  infected  milk.  Apparently,  either  the  conditions  of  the  milk 
supply  of  the  Commonwealth  have  greatly  improved  in  this 
respect,  or  two  years  did  not  cover  enough  time  to  give  a  fair 
average,  or,  as  is  more  likely,  in  the  earlier  series  too  much 
emphasis  was  placed  upon  the  investigation  of  outbreaks  that 
were  suspiciously  indicative  of  milk  infection  from  the  start. 

It  is  very  easy  to  pile  well-proven  epidemic  on  well-proven 
epidemic  to  demonstrate  that  milk  does  transmit  epidemic  dis- 
eases. As  far  back  as  1908  Trask  was  able  to  collect  493  epi- 
demics of  typhoid,  diphtheria  and  scarlet  fever  in  which  the 
evidence  was  conclusive  that  the  cause  was  infected  milk.  An 
enormous  number  of  similar  outbreaks  have  been  reported  since, 
ample  to  prove  that  the  danger  of  milk  transmission  is  serious 
and  real;  but  epidemics  do  not  tell  the  entire  story.  Although 
epidemics  furnish  the  spectacular  element  in  communicable  dis- 


141 


ease  work,  their  total  percentage  importance  is  not  to  be  com- 
pared with  that  of  the  sporadic  cases. 

Out  of  a  total  of  240  epidemics  and  outbreaks  of  typhoid, 
scarlet  fever,  diphtheria  and  septic  sore  throat,  due  to  all  causes, 
investigated  by  the  State  Board  of  Health  of  Massachusetts 
during  the  years  1910  to  1914,  the  total  number  of  cases  given 
by  the  investigators  is  3,198.  But  in  some  instances  no  state- 
ment as  to  the  total  number  can  be  made,  and  in  many  more 
instances  a  number  is  given  with  the  qualification  that  the 
number  is  incomplete.  Even  if  we  assume  that  there  actually 
were  as  many  more  cases  attributable  to  these  outbreaks  as 
are  given,  the  total  number  would  not  greatly  exceed  6,000. 
But  in  the  same  years  a  total  of  85,958  cases  of  these  same 
diseases  were  reported.  Since,  during  these  years,  practically 
every  disease  outbreak  of  any  material  proportions  in  the  Com- 
monwealth has  been  the  subject  of  a  special  investigation  by 
the  State  health  authorities,  and  not  over  6,000  cases,  at  an 
outside  estimate,  can  be  attributed  to  these  outbreaks,  it  would 
follow  that  the  endemic  prevalence  of  these  diseases  is  in  the 
aggregate  of  vastly  greater  public  health  significance  than  the 
more  spectacular  epidemic  prevalence,  —  in  this  instance  at 
least  fourteen  times  as  great. 

The  following  tabular  comparisons  based  on  Massachusetts 
investigations  are  of  interest  in  this  connection :  — 


Summary  of  Epidemiological  Investigations  by  the  State  Inspectors  of  Health 
of  Massachusetts  for  the  Five-year  Period,  1910-14,  inclusive,  with 
Reference  to  Frequency  of  Milk  Transmission. 
(1)     Diphtheria. 


Year. 


Number  of 
Epidemics. 


Due  to 
Milk. 


Due 
to  Other 
Causes. 


Percentage 
Milk-borne. 


1910,  . 

1911,  . 

1912,  . 

1913,  . 

1914,  . 
Totals, 


7.7 
11.0 


3.2 


142 


Summary  of  Epidemiological  Investigations  by  the  State  Inspectors  of  Health 
of  Massachusetts  for  the  Five-year  Period,  1910-14,  inclusive,  with 
Reference  to  Frequency  of  Milk  Transmission  —  Concluded. 


(2) 

Septic  Sore  Throat. 

Year. 

Number  of 
Epidemics. 

Due  to 

Milk. 

Due 
to  Other 
Causes. 

Percentage 
Milk-borne. 

- 

- 

- 

- 

1 

1 

- 

100 

- 

- 

- 

- 

1913 

3 

2 

1 

66 

1914,     . 

2 

1 

1 

50 

6 

4 

2 

66 

(3)     Scarlet  Fever. 


1910,  . 

1911,  . 

1912,  . 

1913,  . 

1914,  . 
Totals, 


S7 


10 

9.0 

9 

10.0 

6 

25.0 

22 

4.3 

33 

6.0 

8.0 


(4)     Typhoid  Fever. 


1910 

1911 

1912 

1913 

1914 

Totals,  .... 
Grand  totals,  all  epidemics, 


240 


53 

194 


66.6 
18.2 
50.0 
25.8 
43.5 


38.4 
19.2 


In  the  above  tabulation  the  incidence  of  more  than  one  case 
in  different  families  in  the  same  locality  at  the  same  time  is 
classed  as  an  epidemic  or  an  outbreak,  with  the  natural  effect 
that,  with  three  or  four  exceptions,  the  average  number  of 
cases,  per  epidemic  is  small.  There  have  been  many  small  out- 
breaks where  no  suspicion  has  been  raised  relative  to  the  milk 
supply  that  have  been  handled  wholly  by  local  authorities,  and 


143 

concerning  which  no  epidemiological  information  is  recorded  in 
the  State  Department  of  Health.  This  fact  does  not  invali- 
date the  significance  of  this  table,  because  for  several  years 
past  it  has  been  the  fixed  policy  of  the  Department  (Board) 
to  investigate  every  case  of  contagious  disease  reported  from 
a  milk-producing  farm,  as  well  as  every  outbreak  whether  in 
a  large  or  small  community  where  milk  was  at  all  under  sus- 
picion. Therefore  a  fuller  table  would  only  tend  to  lessen  the 
percentage  of  milk-borne  epidemics. 

In  the  same  connection  it  is  interesting  to  note  that  in  the 
five  years  55  other  investigations  were  made  by  the  State 
Health  Inspectors  in  instances  when  a  single  case  of  contagious 
disease  was  reported  from  a  milk-producing  farm,  and  precau- 
tions ordered  and  observed,  with  no  secondary  cases  of  any 
nature  subsequently  occurring. 

In  1910  sworn  testimony  was  given  by  Prof.  C.  E.  A.  Wins- 
low  before  the  milk  investigating  committee  of  the  Legislature 
(and  we  have  found  no  contradictory  testimony  on  this  point) 
that  in  less  than  four  years  five  epidemics  due  to  milk  had 
resulted  in  70  cases  of  diphtheria,  700  cases  of  scarlet  fever, 
and  557  cases  of  typhoid  fever  in  Boston  and  its  immediate 
vicinity. 

From  a  combined  source  of  data  (consisting  of  (a)  replies  to 
a  questionnaire  sent  to  the  local  boards  of  health  and  (b)  an 
analysis  of  the  investigations  of  outbreaks  of  infectious  diseases 
made  by  the  State  Inspectors  of  Health)  in  Greater  Boston, 
there  can  reasonably  be  attributed  to  infected  milk  during  tne 
six-year  period,  1909-14  (inclusive),  6  cases  of  diphtheria,  845 
cases  of  scarlet  fever,  1,000+  cases  of  septic  sore  throat  and 
365  cases  of  typhoid.  Thus,  in  five  epidemics  occurring  between 
January,  1907,  and  July,  1910,  1,397  cases  of  milk-borne  infec- 
tious diseases  occurred  in  Greater  Boston,  while  in  the  same 
locality  in  the  six-year  period,  1909-14  (inclusive),  from  all 
available  sources,  2,210+  cases  of  typhoid,  scarlet  fever  and 
septic  sore  throat  have  been  traced  to  milk. 

When  it  is  recalled  that  by  far  the  greater  portion  of  Greater 
Boston's  milk  supply  is  from  pasteurized  sources,  and  that  all 
these  cases  proved  to  have  been  due  to  comparatively  small 
raw  milk  supplies,  the  seriousness  of  the  milk  problem,  as  it 


144 

pertains  to  the  occurrence  of  the  diseases  in  question,  cannot  be 
denied  or  ignored. 

At  one  time  we  contemplated  making  a  similar  analysis  for 
the  same  period  of  the  milk-borne  epidemics  in  comparison  with 
the  total  number  of  epidemics  of  these  same  diseases  reported 
by  those  States  having  the  most  complete  communicable  dis- 
ease reporting  systems.  Correspondence  with  the  epidemiolo- 
gists of  various  States'  indicated  that  such  data  were  not  in 
readily  available  form  in  any  of  them,  and  distance  and  lack 
of  time  have  prevented  us  going  any  further  into  this  most 
interesting  and  suggestive  line  of  investigation. 

A  careful,  although  by  no  means  exhaustive,  search  of  English 
references  throws  no  light  upon  the  subject,  although  we  rather 
suspect  that  such  data  may  be  available.  We  have  made  no 
examinations  in  reference  to  this  point  into  Scandinavian  con- 
tributions to  the  milk  question,  and  consider  that  any  search 
into  the  data  available  from  other  European  countries,  aside 
from  Great  Britain  and  Scandinavia,  would  be  time  wasted 
because  of  (a)  the  widespread  use  of  goat's  milk  in  many  parts 
of  the  continent  milked  in  containers  furnished  by  the  con- 
sumers at  the  consumer's  door,  and  (6)  an  almost  universal 
European  practice  of  boiling  the  milk  as  a  sanitary  precaution. 

(2)  Evidence  as  to  the  Total  Relative  Importance  of 
Milk  Infection  in  the  Transmission  of  Certain  Com- 
municable Diseases  of  Man  based  on  their  Occur- 
rence in  Endemic  or  Sporadic  Form  as  well  as  in 
Epidemics. 

Although  diligently  sought,  practically  no  authoritative  data, 
in  our  opinion,  can  be  obtained  at  present  upon  this  important 
point.  Moreover,  such  statements,  generalizations,  inferences 
and  hypotheses  as  are  found  in  milk  literature  bearing  on  this 
subject  are  not  only  resting  on  far  from  conclusive  epidemio- 
logical foundations,  but  are  in  many  instances  rather  contrary 
to  such  fragmentary  epidemiological  evidence  as  we  have  been 
able  to  uncover. 

It  is  easy  to  see  that  the  temptation  to  make  out  the  case 
against  milk  as  strong  and  startling  as  possible,  buttressed  by 


145 

the  spectacular  corroborative  evidence  of  the  milk-borne  epi- 
demic, has  had  a  tendency  to  produce  these  sweeping  state- 
ments and  charges  in  regard  to  milk  infection. 

It  is  an  interesting  reflection  upon  the  inadequate  develop- 
ment of  practical  disease-preventive  measures  in  this  country 
to  note  that  the  routine  machinery  of  no  State  and  of  but  few 
city  health  departments  is  at  the  present  time  developed  to 
such  a  comparatively  modest  degree  of  efficiency  as  will  enable 
them  to  make  routine  investigations  into  the  reported  cases  of 
these  diseases,  known  to  be  at  times  milk  borne,  sufficient  to 
bring  out  whether  or  not  milk  should  be  considered  as  a  certain 
or  probable  source  of  infection  in  any  given  case  or  group  of 
cases. 

In  the  course  of  its  investigations  this  Board  has  made  a 
careful  and,  we  believe,  a  fairly  representative  study  of  the 
best  available  modern  milk  literature,  with  special  reference  to 
its  bearing  upon  infectious  diseases,  infant  mortality  and  the 
gastroenteritides  of  children. 

We  have  been  forcibly  struck  with  the  casual,  elusive  and 
vague  character  of  statements  which  continually  recur  relative 
to  the  proportional  significance  of  infected  milk  to  these  dis- 
ease conditions. 

The  literature  of  milk,  when  it  comes  down  to  this  concrete 
problem,  either  admits  the  total  inadequacy  of  present  data 
on  the  relative  significance  of  milk  infection  in  disease  trans- 
mission, or  is  discreetly  silent,  or  more  often  takes  refuge  in 
indefinite  and  elusive  generalizations. 

In  attempting  to  arrive  at  some  conclusions  in  this  matter 
the  following  sources  of  evidence  have  been  carefully  con- 
sidered :  — 

(a)  Replies  to  a  questionnaire  sent  to  Massachusetts  cities 
and  towns. 

(6)  Written  and  verbal  statements  of  the  epidemiological 
authorities  of  various  States. 

(c)  The  reports  of  the  special  typhoid  board  of  the  United 
States  Public  Health  and  Marine  Hospital  service  in  the  Dis- 
trict of  Columbia  (1906-10). 

(d)  The  evidence  of  the  records  of  the  Boston  City  Health 


146 

Department  supplemented  by  the  evidence  of  the  records  of 
certain  other  Massachusetts  cities. 

(e)  Epidemiological  resumes  of  the  New  York  City  Health 
Department,  with  special  reference  to  milk,  including  the  resid- 
ual typhoid  theory,  by  Dr.  M.  L.  Ogan  of  the  New  York  City 
Health  Department. 

(/)  "Milk  and  its  Relation  to  the  Public  Health"  (United 
States  Public  Health  and  Marine  Hospital  Service,  Hygienic 
Laboratory  Bulletins  Nos.  41  and  56). 

(g)  Miscellaneous  works  on  milk,  or  incidental  references  to 
milk  in  connection  with  communicable  disease  by  American  and 
foreign  authorities  other  than  above  (practically  all  English). 

(a)     Replies  to  a  Questionnaire  sent  to  Massachusetts  Cities  and 

Towns. 

Owing  to  the  fact  that  Massachusetts  local  boards  of  health 
are  required  by  law  to  report  to  the  State  health  authorities 
only  the  names,  addresses,  diagnoses  and  dates  upon  which 
cases  of  infectious  diseases  are  reported  to  them,  and  that  the 
routine  notifications  to  the  State  Health  Department  are  limited 
strictly  to  this  information,  the  records  of  the  Massachusetts 
State  Health  Department  throw  no  light  whatever  upon  the 
question  under  discussion.  Thinking  that  a  statement  cover- 
ing the  entire  State,  based  on  the  records  of  the  local  boards 
of  health,  would  throw  some  light  on  the  problem,  your  Board 
prepared  and  sent  out  in  July  of  this  year  a  circular  question- 
naire to  all  of  the  local  boards  of  health  in  the  Commonwealth. 
Owing  to  very  incomplete  replies  a  second  letter,  explaining  a 
little  more  in  detail  the  purposes  of  the  inquiry,  was  sent  to 
those  cities  and  towns  that  had  failed  to  reply  in  July.  (See 
Appendix  B.) 

The  form  of  the  questionnaire  was  extremely  simple.  A 
statement  was  requested  of  the  total  number  of  cases  of  typhoid 
fever,  diphtheria,  scarlet  fever  and  septic  sore  throat  reported 
to  the  local  board  during  the  five-year  period,  1909-13;  of  the 
number  recorded  .  as  due  to  milk  infection  following  investiga- 
tion by  the  local  board;  the  number  suspected  of  being  milk 
borne  without  conclusive  evidence  being  obtained;  the  total 
number  of  deaths  from  the  same  diseases  in  the  correspond- 


147 

ing  period,  and  the  number  of  such  deaths  attributed  to  milk 
infection. 

When  we  consider  the  widespread  interest  relative  to  the 
connection  between  the  milk  supply  and  the  public  health  that 
has  prevailed  in  this  Commonwealth  for  some  years  past,  and 
the  amount  of  public  agitation  that  has  arisen  in  relation 
thereto,  it  must  be  confessed  that  the  total  returns  from  this 
questionnaire  were  somewhat  disappointing.  It  was  sent  out 
merely  as  a  means  of  obtaining  the  facts  relative  to  milk  and 
communicable  disease  prevalence,  and  of  supplying  information 
that  the  State  health  authorities  had  no  other  means  of  pro- 
curing, and  we  had  mistakenly  anticipated  a  very  complete 
response.  However,  whether  from  procrastination,  thoughtless- 
ness or  a  deliberate  intent  not  to  co-operate  in  this  matter,  one 
city  and  156  towns,  representing  in  all  a  population  of  556,554, 
or  about  16  per  cent,  of  the  total  population  (Census  1910), 
failed  to  make  any  reply  or  acknowledge  receipt  of  the  two 
requests  up  to  date. 

Of  the  entire  group  of  cities  and  towns  replying,  34  cities 
and  162  towns,  respectively,  representing  a  population  of 
2,809,862  (Census  1910),  or  84  per  cent,  of  the  State,  the 
greater  majority  replied  in  full.  A  number  of  the  smaller 
towns,  however,  simply  replied  "no  records."  We  have  been 
somewhat  in  doubt  whether  to  interpret  this  reply  as  meaning 
that  these  boards  of  health  actually  kept  no  records  of  com- 
municable diseases,  or  whether  it  meant  that  in  the  period 
covered  no  cases  of  the  diseases  concerning  which  information 
was  sought  had  been  reported. 

Forty  towns,  having  an  aggregate  population  of  50,134,  state 
that  no  cases  of  these  diseases  due  to  any  causes  have  been 
reported  in  this  period  to  their  local  boards  of  health.  Inas- 
much as  the  "no  record"  towns  and  "no  cases"  towns  are  all 
comparatively  small,  it  may  be  reasonably  inferred  that  at 
least  no  outbreak  of  these  diseases  could  have  occurred  in  any 
of  them  during  the  period  under  inquiry,  for  such  an  occur- 
rence would  have  been  practically  certain  to  have  become  a 
matter  of  record  in  the  local  board  of  health  office.  It  is  also 
true  that  in  practically  all  of  these  towns  the  machinery  of 
milk  production  and  distribution  is  extremely  simple. 


148 


The  remaining  102  towns  and  the  34  cities  —  answering  the 
questionnaire  represent  a  total  population  of  2,703,759.  They 
report  as  follows :  — 


Diseases. 


Total  Num- 
ber of  Cases, 
1909-13. 


Cases  due 
to  Milk. 


Cases  Milk 
suspected. 1 


Typhoid  fever, 
Diphtheria, 
Scarlet  fever,    . 
Septic  sore  throat, 
Totals, 


11,282 

31,866 

31,012 

2,436 


76,596 


553 

11 

495 

1,914 


2,973 


135 
49 
57 


241 


Diseases. 


Total  Num- 
ber of  Deaths, 
1909-13. 


Deaths  due 
to  Milk. 


Deaths  Milk 
suspected.  l 


Typhoid  fever, 
Diphtheria, 
Scarlet  fever, 
Septic  sore  throat, 
Totals, 


1,425 

2,580 

991 

49 


5,045 


48 


94 


Analysis  of  these  totals  demonstrates  that  in  only  0.03  per 
cent,  of  cases  has  the  transmission  of  diphtheria  been  definitely 
assigned  to  infected  milk,  and  in  only  .19  per  cent,  was  milk 
either  proven  or  suspected;  1.6  per  cent,  of  the  reported  cases 
of  scarlet  fever  have  been  definitely  attributed  to  milk  infec- 
tion, and  1.8  per  cent,  proven  or  suspected;  in  79  per  cent,  of 
the  cases  of  septic  sore  throat  (not  reportable  until  1914)  milk 
was  assigned  as  the  cause;  in  5  per  cent,  of  the  cases  of 
typhoid  milk  was  definitely  assigned  as  the  cause,  and  in  6 
per  cent,  milk  was  either  proven  or  suspected  to  be  the  agent 
of  infection  in  this  disease.  Taking  all  of  these  diseases  in 
a  group,  3.9  per  cent,  were  definitely  attributed  to  milk,  and 
in  4  per  cent,  of  all  the  cases  milk  was  proven  or  suspected. 
Considering  mortality,  3  per  cent,  of  typhoid  deaths  are  possibly 
attributable  to  milk,  0.08  per  cent,  of  diphtheria  deaths,  0.8  per 
cent,  scarlet  fever  deaths,  98  per  cent,  septic  sore  throat  deaths; 
an  average  for  the  whole  group  of  2  per  cent,  of  the  deaths 
may  be  attributed  to  infected  milk. 


1  "Suspected"  here  means  that  milk  was  considered  to  be  the  probable  source  of  infection, 
but  was  not  conclusively  proven. 


149 


(b)  Written  and  Verbal  Statements  of  the  Epidemiological  Author- 
ities of  Various  States. 
Specific  information  upon  the  point  under  discussion,  i.e.,  the 
endemic  prevalence  of  milk  infections,  was  sought  from  the 
epidemiological  authorities  of  the  States  of  New  York,  New 
Jersey,  Pennsylvania,  Maryland,  Minnesota  and  Kansas.  (See 
Appendix  D.)  These  States  were  selected  because  they,  and, 
as  far  as  we  are  aware,  they  only  among  the  several  States, 
have  communicable  disease  reporting  systems  analogous  to  the 
Massachusetts  system.  In  fact,  the  morbidity  reporting  sys- 
tems of  these  States,  which  place  in  the  hands  of  the  State 
health  authorities  the  individual  case  reports  of  communicable 
diseases,  are  supposed  to  furnish  more  direct  epidemiological 
data  than  does  the  Massachusetts  system.  But,  as  was  the 
experience  in  relation  to  the  epidemic  prevalence  of  milk-borne 
infections,  none  of  these  States  was  in  a  position  to  furnish 
even  roughly  approximate  quantitative  returns.  A  resume  of 
the  replies  follows :  — 

Kansas  (correspondence  only) .  —  Reported  only  two  epidemics  trace- 
able to  milk  on  record,  but  stated  that  others  have  occurred.  Could  fur- 
nish nothing  as  to  endemic  frequency  of  milk  infection. 

New  Jersey  (correspondence  only) .  —  Furnished  nothing  on  endemic 
frequency  of  milk  infection.  Referred  to  several  interesting  milk-borne 
epidemics. 

Pennsylvania.  —  No  reply. 

Maryland  (correspondence  and  verbal)  (See  Appendix) .  —  Furnished 
no  data  relative  to  the  endemic  factor  of  milk  in  their  diseases.  Stated 
that  they  have  had  eight  outbreaks  of  typhoid,  aggregating  390  cases, 
which  were  milk  borne,  from  1884  to  date,  and  one  of  septic  sore  throat 
in  1912,  involving  somewhere  between  1,000  and  3,000  cases. 

New  York  (correspondence  and  verbal).  —  Gave  some  interesting 
epidemics,  some  of  considerable  extent,  of  all  the  diseases  under  con- 
sideration. Stated  that  as  yet  no  analysis  of  endemic  prevalence  had  been 
made  by  examining  either  the  records  of  local  boards  of  health,  or  by 
analysis  of  the  original  reports  received  from  physicians  on  file  in  the 
Communicable  Disease  Division  of  the  State  Health  Department,  but 
expressed  an  opinion  that  such  a  study  might  be  profitably  made. 

Minnesota  (correspondence  and  verbal)  (See  Appendix).  —  The  exact 
language  used  in  replying  to  our  letter  of  inquiry  by  the  director  of  the 
Division  of  Preventable  Diseases  of  the  Minnesota  Board  of  Health  is 
as  follows :  — 


150 

Id  endeavoring  to  comply  with  your  request  regarding  instances  in  which  milk 
has  been  implicated  in  the  transmission  of  scarlet  fever,  diphtheria  and  typhoid 
fever  I  am  somewhat  disappointed.  Dr.  Greene  was  kind  enough  to  go  through 
the  records  of  the  division  very  carefully  from  Aug.  1,  1909,  to  date.  He  made  a 
card  index  of  reports  where  it  seemed  that  milk  might  have  been  a  factor  in  the 
spread  of  infection.  I  have  personally  gone  through  all  these  reports.  While  many 
of  them  indicate  that  milk  was  a  factor  to  some  extent  in  the  spread  of  disease,  only 
in  a  few  was  milk  the  chief  route  of  infection,  or  definitely  proven  to  be  even  an 
active  factor.  I  may  say  that  in  several  epidemics  which  I  personally  investigated 
there  was  strong  circumstantial  evidence  indicating  that  milk  was  the  main  route 
of  infection.  However,  careful  investigation  proved  that  appearances  were  de- 
ceiving, for  it  was  readily  shown  that  the  milk  could  not  have  been  infected,  and 
the  cases  suspected  to  be  milk  infections  were  traced  to  direct  contact  with  known 
cases  at  a  time  which  would  fully  account  for  the  infection. 

In  addition,  reference  was  made  to  a  considerable  number  of 
true  milk-borne  epidemics,  including  one  of  typhoid  which  was 
due  to  butter,  another,  also  typhoid,  due  to  both  milk  and 
cheese,  and  five  other  milk-borne  typhoid  outbreaks,  two  diph- 
theria outbreaks,  one  each  from  milk  and  butter,  and  one  definite 
and  three  doubtful  milk  outbreaks  of  scarlet  fever.  In  personal 
interviews  the  director  of  the  Minnesota  Division  of  Preventable 
Diseases  expressed  a  strong  skepticism  as  to  the  comparative 
frequency  of  milk  infection  in  both  sporadic  and  epidemic  cases 
of  these  diseases. 

(c)  The  Reports  of  the  Special  Typhoid  Board  of  the  United 
States  Public  Health  and  Marine  Hospital  Service  on  the 
Origin  and  Prevalence  of  Typhoid  Fever  in  the  District  of 
Columbia  (1906-09). 

Although  these  reports  deal  exclusively  with  typhoid,  yet 
they  have  a  very  great  significance  because  of  the  exceptional 
thoroughness  with  which  the  epidemiological  studies  were  made, 
their  continuance  through  a  series  of  years  (four),  sufficient  to 
offset  to  some  degree  the  exceptional  factors  of  any  single  year, 
and  the  fact  that  the  results  of  this  study  have  in  a  general 
way  passed  current  for  several  years  among  American  sani- 
tarians as  an  approximately  correct  index  to  the  relative  im- 
portance of  milk  infection  to  the  spread  of  typhoid.  In  trying 
to  arrive  at  a  fair  and  just  appreciation  of  the  significance  of 
their  results,  three  facts  need  to  be  borne  in  mind. 

1.  That  the  total  number  of  milk-borne  cases  of  typhoid  re- 
ported upon  in  this  series  are  explicitly  stated  to  be  all  cases 
occurring  under  epidemic  conditions;    in  fact,  to  have  been  due 


151 

to  six  well-defined  epidemics.  It  is  striking  that  such  a  small 
number  of  localized  milk-borne  typhoid  outbreaks  should  have 
produced  so  high  a  percentage  of  the  local  typhoid. 

2.  That  while  the  percentage  of  cases,  attributed  to  milk 
transmission,  for  the  first  three  years  are  all  approximately  10 
per  cent.,  the  fourth  year  the  percentage  drops  abruptly  to  2.2 
per  cent. 

3.  That  the  great  proportion  of  cases  unaccounted  for  may 
or  may  not  have  contained  a  considerable  number  of  cases  in 
which  the  infection  was  milk  borne.  If  so,  and  if  the  milk  epi- 
demics occurring  in  the  three  earlier  years  represent  a  fair  average 
of  the  relative  frequency  with  which  milk-borne  infections  occur, 
the  relative  importance  of  milk-borne  infection  in  typhoid  is 
high.  If  the  contrary  be  true,  its  relative  significance  com- 
pared to  contact,  or  water,  is  perhaps  quite  small. 

Although  these  studies  relate  to  District  of  Columbia  con- 
ditions exclusively,  the  conclusion  is  unescapable,  although  they 
nowhere  definitely  express  such  an  opinion,  that  these  investi- 
gators are  strong  adherents  of  the  view  that  milk  is  a  very 
great  factor,  relatively  speaking,  in  the  transmission  of  Ameri- 
can urban  typhoid.  We  particularly  value  their  evidence  be- 
cause it  rests  on  a  basis  of  careful  epidemiological  work,  and 
is,  together  with  Ogan's  New  York  City  work,  the  only  evi- 
dence we  have  found  that  is  at  all  reliable  pointing  towards  a 
substantiation  of  the  relatively  high  milk  factor  that  has  been 
so  commonly,  not  to  say  recklessly,  assumed  by  so  many 
authorities. 

The-  unqualified  fashion  in  which  these  investigators  commit 
themselves  to  this  "high  milk-borne  percentage"  theory  of 
typhoid  transmission  can  be  clearly  seen  by  the  following 
statements :  — 

Since  so  many  cases  occurred  in  the  course  of  definite  and  readily 
recognizable  milk  outbreaks,  it  is  almost  certain  that  a  number  of  scattering 
cases,  probably  aggregating  more  than  the  number  definitely  attributable  to 
milk-borne  injection,  resulted  from  milk-borne  infection. 

And  again :  — 

In  each  of  the  four  years  the  cases  attributed  to  milk-borne  infection 
comprised  only  the  cases  which  occurred  in  the  course  of  pronounced 


152 

outbreaks  among  the  customers  of  certain  dairymen.  In  view  of  the 
way  in  which  the  bulk  of  the  milk  consumed  in  Washington  is  handled, 
it  may  be  logically  surmised  that  the  proportions  of  cases  caused  by  milk- 
borne  infection  were  considerably  larger  than  the  figures  in  the  summary 
indicate. 

Whether  the  Washington  experience  can  be  assumed  as  fairly 
typical  for  American  cities  is  another  question.  It  is  interest- 
ing to  note  that  although  these  investigators,  reporting  on  a 
population  of  approximately  one-third  of  a  million,  found  six 
distinct  milk-borne  outbreaks  in  a  space  of  four  consecutive 
years,  the  Maryland  State  Board  of  Health,  reporting  for  a 
population  approximately  a  million  greater,  only  recorded  a 
total  of  eight  milk-borne  typhoid  outbreaks  in  thirty-one  years. 
Since  Maryland  all  but  surrounds  the  city  of  Washington,  cli- 
matic, social  and  racial  factors  are  fairly  comparable,  and  even 
though  it  be  conceded  that  a  great  many  outbreaks  have  been 
overlooked  by  the  Maryland  authorities,  as  is  undoubtedly  the 
case,  yet  it  at  once  raises  the  question  as  to  whether  the  three 
years  1906,  1907,  1908  may  not  have  represented  unusually 
high  years  for  milk-borne  typhoid  outbreaks  in  Washington. 

The  investigators  apparently  unhesitatingly  assume  that  the 
low  percentage  of  infection  definitely  attributable  to  milk  dur- 
ing 1909  (2.2  per  cent,  in  contrast  to  the  average  of  10  per 
cent,  so  accounted  for  during  the  three  years  previous)  can  be 
explained  entirely  by  improvement  in  the  milk  supply,  or,  to 
quote  their  own  words:  "The  number  of  cases  definitely  at- 
tributable to  milk-borne  infection  was  considerably  smaller  in 
1909  than  in  any  of  the  three  previous  years,  and  it  appears 
quite  probable  that  the  decrease  in  the  typhoid  rate  in  Wash- 
ington since  1906  has  been  due  in  part  to  the  improvement  in 
the  city's  milk  supply  from  year  to  year." 

No  data  are  given  to  indicate  upon  what  ground  the  state- 
ment relative  to  the  improvement  in  the  city's  milk  supply  is 
based,  but  inasmuch  as  the  percentages  of  the  milk-borne  cases 
for  1906,  1907,  1908  are  remarkably  even,  and  the  1908  per- 
centage exceeds,  although  only  by  a  fraction,  that  of  1907,  it 
is  a  little  difficult  to  deduce  from  this  just  where  the  improve- 
ment "from  year  to  year"  was  manifesting  itself  in  such  a 
fashion  as  to  explain  the  75  per  cent,   "frequency  drop"  of 


153 

1909,  and  we  respectfully  suggest  that  these  consecutive  "high 
percentages"  years  may  have  been  of  themselves  an  anomaly. 

Every  analysis  of  the  six  outbreaks  listed  by  these  in- 
vestigators discloses  several  interesting  facts.  In  1908  one 
distinct  outbreak  is  recorded  involving  52  cases.  This  out- 
break was  followed  up,  the  carrier  detected,  typhoid  bacilli  iso- 
lated from  her  feces,  sale  of  milk  from  her  premises  stopped, 
and  the  outbreak  abruptly  terminated.  This  outbreak  cer- 
tainly fulfilled  the  most  exacting  epidemiological  requirements 
of  proof. 

In  1909  the  single  outbreak  attributed  to  milk  failed  of  con- 
firmation by  application  of  laboratory  methods  for  detection 
of  carriers  to  all  who  had  to  do  with  the  milk,  although  the 
circumstantial  epidemiological  evidence  was  very  strong. 

In  the  other  four  epidemics,  so  far  as  the  evidence  appears, 
the  only  basis  for  classifying  these  groups  of  typhoid  fever  as 
distinct  milk  outbreaks  was  the  suspicious  frequency  of  the 
occurrence  of  typhoid  cases  upon  the  routes  of  certain  dealers. 

We  admit  that  this  reasoning  is  plausible,  but  in  the  absence 
of  any  statement  as  to  past  epidemiological  history  of  milk 
producers  on  the  farms  and  the  dairy  employees  distributing 
these  milks,  and  in  the  absence  of  any  laboratory  confirmative 
work,  we  consider .  that  the  conclusions  do  not  rest  upon  suf- 
ficiently sound  epidemiological  proofs  to  consider  them  as  fairly 
attributable. 

Therefore,  in  all,  we  find  but  one  of  these  six  outbreaks  com- 
pletely proved  (the  carrier  case  in  1908).  The  other  five  out- 
breaks, which  the  authors  consider  as  positive  outbreaks,  all 
present  gaps  in  evidence  of  more  or  less  serious  nature. 

Another  extremely  interesting  observation  by  the  authors  is 
the  following:  In  the  last  year  reported  they  state  that  4 
dairymen,  all  doing  a  relatively  large  business,  were  that  year 
pasteurizing  their  milk,  and  they  make  the  observation  that 
1  of  them  had  practiced  pasteurization  for  the  whole  period 
(four  years);  2  only  began  in  the  middle  of  1908;  and  1,  July 
1,  1909.  They  present  a  table  showing  that  the  number  of 
cases  on  these  three  dealers'  routes  per  100,000  gallons  of  milk 
distributed  had  shown  a  sharp  decline  since  inaugurating  pas- 
teurization.    This  argument  is  rather  weak,  in  our  opinion,  for 


154 


the  periods  both  before  and  after  pasteurization  are  too  short 
to  justify  any  deductions  as  to  the  cause  and  effect  connection 
between  pasteurization  and  typhoid  incidence,  although  in  the 
case  of  the  dealer  who  pasteurized  throughout,  and  consistently 
had  low  incidence  per  100,000  gallons,  the  argument  may  be 
given  some  weight. 

The  rates  of  typhoid  incidence  per  100,000  gallons  of  milk 
distributed,  given  year  by  year  for  the  three  dealers,  are  as 
follows  (the  heavy-faced  figures  indicate  time  when  pasteuriza- 
tion began) :  — 


No.  3. 


No.  4. 


No.  8. 


1906, 
1907, 
1908, 
1909, 


16.6 
7.1 
5.8 
1.4 


52.5 

21.6 

10.1 

7.0 


35.6 
17.1 
18.8 


It  is  possible  to  pick  three  other  dealers,  also  selling  large 
amounts,  who  never  pasteurized,  and  show  the  same  striking 
tabular  drops;    for  example:  — 


No.  2. 


No.  5. 


No.  7. 


1906, 
1907, 
1908, 
1909, 


21.5 

23.4 
10.2 
4.2 


23.7 
15.6 
13.3 
8.0 


35.0 
13.6 
9.1 

7.8 


The  investigators  seem  to  believe  that  their  pasteurization 
showing  is  strong  corroborative  proof  of  milk  infection  being 
a  very  important  factor  in  the  transmission  of  typhoid.  If  all 
four  of  the  dealers  who  pasteurized  their  product  in  1909  are  con- 
sidered in  a  group,  their  total  output  is  799,000  gallons  of  pas- 
teurized milk.  They  also  had  a  total  of  39  cases  of  typhoid 
on  their  routes.  Presumably  the  majority  of  these,  at  least, 
would  be  considered  as  due  to  other  causes  than  milk  by  the 
investigators.  But  if  the  16  other  dealers,  whose  total  gallon 
outputs  are  similarly  given,  are  considered  as  one  group,  an 


155 

interesting  comparison  ensues.  In  this  group  there  is  a  total 
output  of  1,514,000  gallons  of  unpasteurized  milk,  and  there 
occurred  98  cases  of  typhoid  on  their  routes.  However,  among 
them  is  the  one  very  small  dealer  (putting  out  only  7,000  gal- 
lons in  the  period)  on  whose  route  occurred  the  outbreak  of  13 
cases,  which  have  been  considered  by  the  investigators  as  un- 
questionably milk  borne.  Deducting  these,  it  leaves  a  total 
of  85  cases  to  1,507,000  gallons  of  milk  distributed.  But  the 
ratios  of  39  to  799,000  and  85  to  1,507,000  are  substantially  the 
same. 

We  would  not  have  our  exceptions  to  their  pasteurization 
argument  interpreted  as  meaning  that  we  are  skeptical  as  to 
the  value  of  efficient  pasteurization  as  an  agency  in  controlling 
disease  transmission  through  milk.  We  merely  wish  to  point 
out  that,  so  far  as  the  Washington  typhoid  series  are  concerned, 
pasteurization  was  not  applied  long  enough  or  generally  enough 
to  fairly  attribute  typhoid  reduction  to  its  influence.  This 
mathematical  comparison  leaves  the  arguments  of  the  inves- 
tigators, in  which  they  give  the  impression  that  milk  infection 
is  a  major  although  undeterminable  factor  in  the  spread  of 
the  Washington  typhoid  of  unattributed  causation,  rather  up 
in  the  air.  For  it  is  quite  evident  that  they  are  citing  the 
progressive  decline  in  the  number  of  cases  per  100,000  gallons 
of  milk  distributed  on  the  routes  of  the  dairymen  practicing 
pasteurization,  after  the  institution  of  the  practice,  as  inferen- 
tial evidence  that  milk  infection  played  a  large  part  in  the 
transmission  of  typhoid  on  their  routes  before  they  began  pas- 
teurization. 

(d)     The  Evidence  of  the  Records  of  the  Boston  City  Health  De- 
partment supplemented  by  the  Evidence  of  the  Records  of 
Certain  Other  Massachusetts  Cities. 
It  is  a  source  of  regret  to  your  Board  that  we  did  not  earlier 
realize  the  great  possibilities  of  a  more  extensive  quantitative 
analysis  of  the  records  of  communicable  diseases  of  the  large 
cities  of  the  country  having  well-equipped  health  departments, 
in  reference  to  the  question  of  the  frequency  of  milk  transmis- 
sion of  disease.    To  make  this  study  of  most  value,  the  precise 
methods  followed  as  to  epidemiological  and  laboratory  proce- 


156 

dure  by  each  city  would  need  to  be  clearly  known,  the  relative 
efficiency  of  reporting  by  physicians,  the  proportion  of  certified 
and  pasteurized  milk  used  and  periods  when  introduced,  and 
above  all,  the  basis  upon  which  each  department  made  its 
routine  classification  as  the  channels  of  transmission.  Studies 
among  cities  of  under  100,000  would  not  be  of  the  same  rela- 
tive weight,  because  the  total  series  could  not  be  sufficiently 
large  to  safely  draw  true  relative  deductions. 

But  we  believe  that  carefully  analyzed  returns  from  city 
health  departments  of  such  standards  as  those  of  Boston,  Provi- 
dence, Baltimore,  New  York,  Chicago,  Seattle,  and  many  others 
where  careful  epidemiological  and  laboratory  work  is  carried 
out  on  every  communicable  disease  case  as  a  routine,  would 
throw  a  great  deal  of  light  upon  this  very  dark  subject. 

Because  of  the  fact  that  the  records  of  the  Boston  City 
Health  Department  have  been  immediately  accessible  to  your 
Board,  we  have  had  opportunity  to  appraise  carefully  the 
methods  of  procedure  upon  which  these  classifications  rest,  and 
the  more  we  have  gone  into  this  subject,  through  conference 
with  the  authorities  of  the  Boston  Health  Department,  the 
more  we  have  been  impressed  with  the  thoroughness  and  relia- 
bility of  their  routine  investigations  of  communicable  diseases 
as  regards  the  demonstrable  or  probable  sources  of  infection. 
On  these  grounds,  on  account  of  the  large  aggregate  number  of 
cases  and  the  very  evident  high  degree  of  co-operation  on  the 
part  of  the  practicing  physicians  of  the  city  in  reporting  and 
suggesting  epidemiological  clues  to  the  health  officials,  we  place 
a  very  high  degree  of  confidence  in  their  returns. 

According  to  the  data  furnished  us  by  the  Division  of  Com- 
municable Diseases  of  the  Boston  City  Health  Department,  out 
of  a  grand  total  of  23,336  cases  of  typhoid,  diphtheria,  scarlet 
fever  and  septic  sore  throat,  recorded  by  the  Department  in 
the  five-year  period,  1909-13,  inclusive,  only  1,132  cases  have 
been  attributed  to  milk-borne  infection,  following  careful  epi- 
demiological investigations  of  each  individual  case.  In  Boston  the 
physicians  practically  never  report  a  case  of  streptococcic  throat 
infection  as  "septic  sore  throat,"  except  in  the  presence  of  a 
milk-borne  epidemic.  Therefore  the  percentage  of  septic  sore 
throat  among  the  milk-borne  diseases  is  practically  100  per 
cent.     When  this  disease  is  excluded  the  relative  proportions 


157 


are:  total  diphtheria,  scarlet  fever  and  typhoid  cases,  22,536; 
total  cases  of  same  diseases  attributed  to  milk,  332.  This  gives 
milk  a  total  percentage  importance  among  the  total  channels 
of  infection  for  these  diseases  for  the  city  of  Boston,  for  five 
years,  of  approximately  1.5  per  cent.  If  septic  sore  throat  is 
included,  the  total  percentage  of  cases  due  to  infected  milk  for 
the  entire  group  of  the  four  diseases  rises  to  approximately 
5  per  cent. 

The  most  interesting  point  of  all  in  connection  with  the 
Boston  experience  is  that  all  of  these  cases  occurred  in  non- 
pasteurized  milk  supplies.  However,  the  number  of  dealers  in- 
volved in  these  non-pasteurized  supplies  are  about  250,  or  83 
per  cent,  of  the  total  number  of  dealers. 

The  percentage  of  pasteurized  supply  to  the  total  supply 
has  considerably  increased  during  the  five  years.  The  B°ston 
Health  Department  estimates  the  percentage  of  pasteurized 
milk  (including  cream)  in  these  years  to  be  as  follows :  — 


Per  Cent. 


Gallons  sold 
Yearly. 


1909, 
1910, 
1911, 
1912, 
1913, 

Average, 


30.68 
49.90 
73.62 
70.59 
80.63 


62.63 


22,297,722 
23,150,125 
24,170,026 
24,745,423 
27,635,785 


24,499,785 


The  Boston  authorities  feel,  and  with  good  epidemiological 
basis,  that  the  extension  of  pasteurization  has  been  a  most 
efficacious  safeguard  against  the  possible  more  extensive  trans- 
mission of  outbreaks  of  the  diseases  under  consideration  through 
milk. 

But  apparently,  just  as  in  the  case  of  the  Washington,  D.  C, 
typhoid  series,  it  is  scarcely  justifiable  to  conclude  that  there 
would  of  necessity  have  been  a  much  greater  occurrence  of  milk- 
borne  diseases  in  the  city  if  the  milk  had  not  been  so  generally 
pasteurized  than  actually  was  the  case. 

Seven  other  of  the  larger  cities  of  Massachusetts  —  Fall 
River,  Pittsfield,  Brockton,  Lowell,  New  Bedford,  Springfield 
and    Worcester  —  had    in    1910    an    aggregate    population    of 


158 

646,152.  This  population  is  fairly  comparable  to  the  popula- 
tion of  Boston  in  1910,  —  670,586.  But  only  two  of  these  — 
Springfield  and  Worcester  —  have  at  present  a  considerable 
percentage  of  milk  pasteurized.  Springfield  has  38  per  cent, 
pasteurized;  Worcester,  30  per  cent.;  Fall  River,  14  per  cent.; 
Brockton,  8  per  cent.;  Lowell,  7  per  cent.;  Pittsfield,  0  per 
cent.  New  Bedford  states  that  practically  none  of  the  milk 
supply  of  that  city  is  pasteurized.  This  gives  an  average  pas- 
teurization of  19.5  per  cent,  for  this  group. 

The  total  number  of  diphtheria  cases  returned  during  the 
same  five-year  period  as  definitely  or  possibly  due  to  milk  in- 
fection for  this  group  of  cities  is  0;  of  septic  sore  throat,  0;  of 
scarlet  fever,  0;  and  of  typhoid,  280.  The  total  number  of 
cases  of  diphtheria,  scarlet  fever,  septic  sore  throat  and  typhoid 
returned  by  this  group  for  the  same  period  is  16,948.  This 
gives  a  percentage  of  milk-borne  cases  of  these  diseases  (in  this 
series,  all  typhoid),  for  the  five-year  period  for  these  cities,  of 
1.5  per  cent.,  the  same  as  the  Boston  percentage  for  five  years 
(omitting  the  septic  sore  throat  cases)  of  1.5  per  cent. 

Such  results  as  these  were  not  in  the  least  anticipated  when 
we  began  this  quantitative  study.  We  confess  to  surprise,  even 
astonishment  at  reaching  quantitative  results  so  far  apart  from 
those  generally  current  as  to  the  relative  frequency  of  milk 
infection.  What  can  such  results  mean?  Do  they  mean  that 
milk  outbreaks  have  been  overlooked  right  and  left  by  these 
city  departments?  Very  possible,  but  not  probable.  All  of 
these  departments  are  considered  efficient.  If  pasteurization 
is  as  important  as  we  have  always  been  led  to  believe  in  stop- 
ping the  incidence  of  milk-borne  infection,  and  if  milk-borne 
infections  are  anywhere  nearly  as  frequent  an  occurrence  in 
non-supervised  milk  supplies  as  has  been  practically  universally 
assumed  for  years,  then  the  relative  percentage  of  milk-borne 
infections  in  these  cities  from  unmistakable  outbreaks  ought  to 
be  materially  higher  than  the  percentage  of  Boston's  milk-borne 
outbreaks,  due  in  every  instance  to  that  city's  relatively  small 
raw  milk  supply. 

These  points  are  suggestive :  — 

First.  — r  It  is  rather  surprising  to  find  that  these  7  cities, 
whose  aggregate  population  is  only  slightly  less  than  that  of 
Boston,  report  only  about  three-fourths  as  many  cases  of  the 


159 

diseases  under  consideration  pom  all  causes.  Whether  this 
means  less  efficient  reporting  by  the  physicians  of  these  cities, 
or  an  actual  lower  frequency  of  occurrence  of  these  diseases 
than  in  Boston,  we  are  unable  to  determine  accurately,  but 
we  believe  the  latter  rather  than  the  former  factor  is  princi- 
pally concerned. 

Second.  —  If  milk  were  in  reality  a  considerable  factor  in 
the  causation  of  sporadic  cases  of  these  diseases  there  should 
be  a  reflection  of  this  effect  in  an  increase  of  the  general  fre- 
quency rate  of  these  diseases,  —  the  exact  antithesis  of  what 
is  found. 

Third.  —  Another  possible  explanation  of  this  discrepancy  in 
the  comparative  frequency  of  incidence  of  diphtheria,  scarlet 
fever  and  typhoid  in  this  group  of  cities,  when  contrasted  with 
Boston,  may  be  their  smaller  concentration  of  mass  of  popu- 
lation, with  its  concomitant  lessened  opportunities  for  contact 
infection. 

Fourth.  —  For  the  most  part  the  milk  supply  of  these  cities 
is  subject  to  the  "short  haul."  Just  what  relation  this  may 
possibly  have  in  reference  to  the  transmission  of  communicable 
diseases  it  is  difficult  to  state,  especially  as  all  the  dairies  im- 
plicated in  the  Boston  series  are  also  "short  haul"  dairies. 

Fifth.  —  Nearly  two-thirds  of  all  the  cases  returned  as  due 
to  milk  infection  in  this  group  are  attributable  to  one  carefully 
demonstrated  typhoid  milk  infection  from  a  urinary  carrier. 

This  again  rather  suggests  that  milk-borne  typhoid,  scarlet 
fever  and  diphtheria  are  possibly  essentially  epidemic  rather 
than  sporadic  in  nature;  that  possibly  they  occur  only  when 
a  certain  complete  chain  of  circumstances  in  reference  to  the 
carrier  or  infected  person  and  milk  exists,  permitting  a  rather 
massive  infection  of  the  milk;  and  that  these  circumstances 
do  not  occur  nearly  as  often,  in  the  aggregate,  as  we  have 
been  led  to  believe  from  the  spectacular  and  striking  character 
of  the  results  when  such  infections  do  take  place. 

(e)     The  Residual  Typhoid  Theory  of  Ogan. 
Probably  no  other  city  in  the  country  makes  as  careful  a 
study  of  its  communicable  diseases  from  the  standpoint  of  epi- 
demiology as  New  York.    Dr.  M.  L.  Ogan,  chief  of  the  Division 
of  Epidemiology  of  that  Department,  has  made  some  interest- 


160 

ing  and  suggestive  studies  as  to  the  possible  milk  factor  in  the 
transmission  of  typhoid  in  that  city. 

His  results  are  particularly  interesting,  as  he  comes  to  the 
conclusion  that  probably  30  per  cent,  of  the  endemic  typhoid 
in  1912  —  the  last  year  before  pasteurization  became  practi- 
cally universal  in  New  York  —  was  due  to  infection  through 
milk.  To  abstract  his  own  words,  this  conclusion  was  arrived 
at  by  noting  that  one  large  company  supplying  325,000  people, 
or  12  per  cent,  of  the  population  of  Manhattan  borough,  had 
among  its  patrons,  using  its  milk  exclusively,  111  cases  of 
typhoid  in  1912.  At  this  ratio  the  whole  population,  had  it 
used  this  milk  exclusively,  should  have  had  only  839  cases, 
assuming  that  pasteurized  milk  could  not  transmit  typhoid; 
but  from  the  whole  population  1,184  cases  were  reported  for 
the  year,  hence  there  is  left  a  residue  of  345  cases,  or  30  per 
cent,  of  the  whole,  which  according  to  this  method  of  reasoning 
(italics  ours)  are  due  to  milk.  The  author  then  adds  another 
9  per  cent,  which  was  attributed  —  on  good  epidemiological 
grounds,  we  assume,  although  the  method  or  basis  of  classifi- 
cation is  not  given  —  to  milk-borne  epidemics,  and  concludes 
that  it  is  not  unreasonable  to  attribute  a  total  of  39  per  cent, 
of  the  borough's  typhoid  of  that  year  to  milk  (30  per  cent, 
endemic  plus  9  per  cent,  epidemic).  He  then  admits  that  other 
factors  might  have  had  an  effect  in  the  reduction  of  typhoid 
between  1911  and  1914  which  is  in  all  53  per  cent.,  mentioning 
better  oyster  supply,  better  water  supply,  more  stringent  food 
handling  sanitary  regulations,  and  advance  in  sanitary  intelli- 
gence on  the  part  of  the  general  public.  He  also  states  that 
this  method  of  computing  the  residual  milk  factor  in  typhoid 
is  open  to  some  criticism,  and  in  this  last  we  are  forced  to 
agree  witji  him. 

In  brief,  while  we  cannot  but  admire  the  ingenuity  of  his 
reasoning,  and  have  the  deepest  respect  for  the  painstaking 
epidemiological  and  laboratory  work  that  lies  back  of  it,  we 
cannot  see  that  his  conclusions  are  justifiable;  too  many  other 
possible  factors  still  remain  unexcluded. 


161 


(/)  "Milk  and  its  Relationship  to  the  Public  Health"  {Bulletins 
No.  41  and  56  of  the  Hygienic  Laboratory,  United  States 
Public  Health  and  Marine  Hospital  Service,  1908). 

This  report  has  a  rather  unique  claim  to  authority  among 
the  contributions  to  the  literature  of  milk.  It  represents  the 
final  joint  conclusions  of  the  medical  and  agricultural  experts 
of  the  Federal  government  upon  this  subject,  based  on  pains- 
taking studies  and  researches  of  their  own,  as  well  as  careful 
and  exhaustive  reviews  of  the  results  of  other  workers  through- 
out the  world.  It  may  be  safely  rated  as  one  of  the  most,  if 
not  the  most,  painstaking  investigations  into  the  subject  ever 
known.     It  fills  a  bulky  volume  of  over  800  pages. 

Nevertheless,  in  searching  carefully  through  it  for  information 
as  to  the  quantitative  relation  between  infected  milk  and  the 
transmission  of  infectious  diseases,  the  nearest  to  a  definite 
statement  that  we  can  find  is  the  following  rather  cryptic  sen- 
tence by  Eager.  He  says:  "The  effect  of  milk  epidemics  on 
morbidity  and  mortality  returns  may  be  surmised  by  the  fre- 
quency with  which  such  epidemics  occur." 

Such  statements  as  these  are  simply  concealing  our  ignorance 
of  this  subject,  our  utter  lack  of  reliable  knowledge,  by  impres- 
sive sounding  phrases  that  get  us  nowhere.  Moreover,  if  Mas- 
sachusetts' experience  is  in  the  slightest  degree  reliable,  the 
prevalence  of  these  diseases  in  epidemics  due  to  all  causes 
bears  but  a  minor  percentage  relation  to  their  total  occur- 
rence, and,  among  epidemics,  only  a  minor  percentage  can  be 
justly  attributed  to  milk. 

(g)     General  Literature  of  Milk  {American  and  Foreign). 

We  have  studied  carefully,  though  by  no  means  exhaustively, 
American  and  English  authorities  for  definite  statements  based 
on  sound  epidemiological  studies  relative  to  the  comparative 
importance  of  milk  transmission  in  the  spread  of  those  com- 
municable diseases  of  man  which  are  transmitted  at  times 
through  the  medium  of  infected  milk.  The  general  consensus 
of  expert  opinion  relative  to  tuberculosis  and  milk  has  already 
been  covered. 

In  studying  the  general  literature  of  milk  and  the  literature 


162 

of  epidemiology  in  respect  to  its  incidental  discussions  of  milk 
transmission  of  diseases,  especially  in  reference  to  the  great 
trio  of  epidemic  diseases  that  are  universally  conceded  to  be 
at  times  milk  borne,  —  i.e.,  diphtheria,  scarlet  fever  and  ty- 
phoid, —  statements  continually  recur  of  which  the  best  that 
can  be  said  is  that  they  shade  from  the  frankly  negative,  or 
the  evidently  purposely  vague,  to  the  entirely  hypothetical  in 
reference  to  this  important  problem. 

As  we  have  repeatedly  pointed  out,  the  striking  spectacular 
evidence  is  always  that  of  the  milk-borne,  or  alleged  milk- 
borne,  epidemic,  and  this  type  has  been  given  the  entire  atten- 
tion of  the  authorities  that  we  have  consulted,  with  one  notable 
and  authoritative  exception,  —  Chapin.  When  some  incidental 
reference  is  made  to  the  problem  of  the  relative  significance  of 
milk  infection,  about  the  only  surmises  hazarded  are  in  refer- 
ence to  typhoid.  Three  in  particular  have  struck  our  attention 
forcibly  from  the  widespread  manner  in  which  they  are  quoted 
as  a  basis  for  judgment.  One  is  the  now  classical  report  by 
Harrington,  in  reference  to  14  out  of  a  total  of  18  typhoid  out- 
breaks in  Massachusetts  being  due  to  milk.  Another  is  the 
assumed  10  per  cent,  factor  of  milk  infection  in  typhoid  trans- 
mission of  the  Typhoid  Board  of  the  United  States  Public 
Health  and  Marine  Hospital  Service  for  the  District  of  Colum- 
bia. We  have  already  discussed  the  fairness  of  these  two  con- 
clusions in  detail.  A  third  reference  is  worthy  of  special  notice, 
as  it  has  been  quoted  quite  as  widely  as  the  other  two,  and  be- 
cause it  may  be  fairly  cited  as  a  typical  example  of  the  sweep- 
ing generalizations  as  to  the  dangers  of  milk  that  can  be  found 
in  many  quarters.  We  refer  to  Whipple's  well-known  work  on 
"Typhoid  Fever."  Another  reason  why  we  feel  it  is  particu- 
larly worthy  of  citation  is  because  the  eminent  author  frankly 
admits  that  the  assertion  rests  on  no  solid  epidemiological  basis, 
and  because  in  justice  to  him  it  should  be  noted  that  in  an- 
other chapter  of  the  same  work,  devoted  exclusively  to  the 
effect  of  milk  supplies  upon  typhoid  rates  of  cities,  he  par- 
ticularly gives  this  wise  caution  in  reference  to  the  matter: 
"...  the  data  for  a  fair  discussion  of  this  subject  have  not 
yet  been  collected."  We  have  never  found  this  statement 
quoted. 


163 

But  very  casually  on  another  page  in  the  chapter  devoted  to 
the  distribution  of  typhoid  he  makes  this  incautious  statement 
which  we  have  found  quoted,  apparently  with  approbation,  in 
numerous  places:  "In  a  general  sort  of  way  it  may  be  said 
that  in  the  cities  of  the  United  States  at  the  present  time 
about  40  per  cent,  of  the  typhoid  fever  is  due  to  water,  25  per 
cent,  to  milk,  30  per  cent,  to  ordinary  contagion  (including  fly 
transmission),  and  about  5  per  cent,  to  all  other  causes." 

The  one  good  authority  who  challenges  the  fairness  and  ac- 
curacy of  these  assertions  as  to  the  high  percentage  importance 
of  milk  infection  in  the  transmission  of  diphtheria,  scarlet  fever 
and  typhoid  is  Chapin  of  Providence.  In  his  work  on  "The 
Sources  and  Modes  of  Infection"  he  says:  — 

It  will  be  noted  that  though  scores  of  outbreaks  of  typhoid  fever  may 
occur  each  year,  they  do  not  include  more  than  a  small  fraction  of  the 
total  typhoid  fever.  It  may  be  claimed  that  only  a  small  proportion  of  the 
milk-borne  outbreaks  are  recognized  as  such,  but  I  cannot  think  that 
this  is  so  in  the  English  cities  and  the  better  class  of  American  cities.  .  .  . 
We  can  hardly  believe  that  milk  outbreaks  could  have,  except  rarely,, 
escaped  detection  in  the  English  cities,  or  in  such  cities  as  Boston,  Worces- 
ter, Springfield,  Rochester,  Baltimore,  Philadelphia  and  New  York. 

The  importance  and  value  of  the  reports  on  typhoid  fever  in  Washing- 
ton have,  as  it  appears,  given  a  rather  exaggerated  importance  to  the 
danger  from  milk.  That  there  was  a  certain  amount  of  typhoid  fever 
in  Washington,  due  to  milk,  during  the  three  years  in  question,  is  no 
reason  for  assuming  a  similar  percentage  of  milk-borne  typhoid  fever  for 
the  other  cities  of  the  country.  Trask  was  able  to  find  during  the  years 
1903-07  about  1,900  cases  in  the  United  States  traced  to  milk.  During 
this  period  there  were  in  the  registration  area  57,023  deaths,  and  the 
total  number  in  the  whole  country  must  have  been  at  least  double,  or 
114,000.  The  fatality  is  probably  not  over  10  per  cent.,  so  that  there 
must  have  been  at  least  1,000,000  cases.  Nineteen  hundred  is  0.19  per 
cent.,  which  is  very  different  from  the  10  per  cent,  now  commonly  assumed 
as  due  to  milk.  I  do  not  of  course  believe  that  all  the  milk  outbreaks 
were  reported,  but  the  number  would  have  to  be  increased  fiftyfold  to 
equal  10  per  cent.,  and  it  can  scarcely  be  believed  that  98  per  cent,  of  all 
milk  outbreaks  fail  of  recognition. 

In  reference  to  diphtheria  and  scarlet  fever  transmission  by 
milk,  he  further  states :  — 

Scarlet  fever  and  diphtheria  are  certainly  much  more  rarely  trans- 
mitted by  means  of  milk  than  is  typhoid  fever.    Although  the  percentage 


164 

of  typhoid  fever,  scarlet  fever  and  diphtheria  due  to  milk  is  small,  the 
danger  is  a  real  one  and  the  aggregate  of  cases  not  inconsiderable  and 
their  occurrence  should,  if  possible,  be  guarded  against. 

In  all  this  epidemiological  quagmire  it  is  refreshing  to  be 
able  to  quote  at  least  one  authoritative,  incisive,  sane  voice 
emphatically  demanding  that  in  making  our  final  judgments 
in  this  matter  we  take  our  stand  upon  the  definitely  proven 
facts,  and  do  not  pass  judgment  in  advance  relative  to  the 
great  mass  of  cases  of  infectious  diseases  whose  etiology  we 
must  as  yet,  in  all  fairness,  class  as  unproven. 

Summary  of  Evidence  available  as  to  the  Relative  Im- 
portance of  Milk  in  the  Transmission  of  Infectious 
Diseases. 

To  sum  up,  the  best  available  information  as  to  the  propor- 
tionate part  played  by  milk  supplies  in  general  in  the  trans- 
mission of  the  great  trio  of  milk-borne  epidemic  diseases  — 
diphtheria,  scarlet  fever  and  typhoid  —  amounts  in  substance 
to  about  as  follows :  —    , 

1.  That  there  have,  been  throughout  the  civilized  world  up 
to  the  present  time  a  large  number  of  well-authenticated  epi- 
demics of  all  of  these  diseases,  definitely  due  to  milk  infection. 
No  one  can  state  at  present  just  how  many  such  epidemics 
there  are  on  record,  but  they  are  ample  in  number  to  prove 
the  danger  of  disease  transmission  through  raw  milk.  From 
the  accumulated  evidence  it  is  possible  to  state  quite  defi- 
nitely that  there  is  a  vast  discrepancy  as  to  the  relative 
frequency  of  milk  infection  in  these  diseases,  diphtheria  being 
clearly  the  least  often  so  transmitted,  scarlet  fever  relatively 
more  often,  and  typhoid  unquestionably  more  frequently  than 
both  the  other  two  combined.  The  fourth,  as  yet  little  under- 
stood disease,  that  is  known  to  be  transmitted  by  milk  —  septic 
sore  throat  —  is,  in  the  best  understanding  of  the  term  now- 
adays, considered  to  be  practically  always  a  milk  infection. 

2.  That  analysis  of  both  the  epidemic  and  endemic  records 
of  these  diseases  in  the  State  of  Massachusetts  for  several  years 
past  would  tend  to  indicate  that  the  total  relative  importance 
of  infected  milk  in  the  transmission  of  these  diseases  is  not 
nearly  as  great  as  has  been  commonly  assumed. 


165 

3.  From  a  study  of  all  the  available  literature  on  the  sub- 
ject it  would  appear  that  three  sources  have  been  largely  re- 
sponsible for  the  widespread  impression  among  American  sani- 
tarians that  milk  infection  has  been  definitely  proven  to  be  a 
high  factor  in  the  transmission  of  these  diseases.  They  curi- 
ously all  relate  to  typhoid  alone.  They  are:  (a)  Harrington's 
report  of  14  out  of  18  typhoid  epidemics  being  found  due  to 
milk;  (b)  the  reports  of  the  special  typhoid  board  on  the  origin 
and  prevalence  of  typhoid  in  the  District  of  Columbia;  and 
(c)  the  milk  percentage  statement  by  Whipple  in  his  work  on 
typhoid  fever.  We  are  unable  to  substantiate  the  conclusions 
of  any  of  these  reports  for  reasons  detailed  above. 

4.  Replies  to  inquiries  among  prominent  American  epidemi- 
ologists are  unanimous  in  testifying  that  the  evidence  as  to 
just  what  part  milk  plays  in  the  transmission  of  these  diseases 
is  not  by  any  means  conclusive.  Almost  without  exception 
they  admit  that  the  tendency  of  their  own  experiences  is  to 
explain  more  and  more  cases  of  these  diseases  on  other  grounds 
than  milk. 

5.  We  can  find  nothing  authoritative  in  any  other  general 
public  health  or  medical  literature  that  throws  any  conclusive 
light  on  this  point. 

6.  The  high  residual  milk-borne  typhoid  argument  of  Ogan 
of  the  New  York  City  Health  Department  is  a  very  suggestive 
theory,  but  in  our  opinion  not  in  any  sense  conclusive. 

7.  Our  own  results  do  not  in  any  sense  prove  conclusively  that 
milk  is  not  as  important  a  factor  as  has  been  assumed.  They 
simply  go  a  long  way  towards  demonstrating  that  the  reasons 
hitherto  given  for  the  assumption  that  milk  is  a  large  factor 
in  the  transmission  of  infectious  diseases  are  in  many  respects 
inadequate  and  unsatisfactory. 

In  brief,  it  is  our  belief  that  all  statements,  conclusions  and 
broad  general  impressions  as  to  the  relative  dangers  of  milk 
found  in  the  literature  rest  on  a  most  shaky  and  unsubstantial 
basis. 

We  believe  that  this  tendency  is  wrong.  The  accumulated 
evidence  of  scores  upon  scores  of  definitely  demonstrated  milk- 
borne  epidemics  is  enough  to  show  that  raw  market  milk  is 
always  a  risky  food.  Why  not  let  it  go  at  that?  Why  lend 
color  to  the  charge  that  practical  milk  producers  so  often  have 


166 

flung  in  our  faces  during  the  progress  of  this  investigation,  viz., 
that  the  tendency  of  sanitarians  to-day  is  to  create  the  im- 
pression that  milk  is  inherently  little  if  any  short  of  a  poison. 
This  impression  has  been  undoubtedly  created  in  many  people's 
minds  by  sweeping,  startling,  unqualified  accusations  against 
cow's  milk  that  may  or  may  not  be  justified,  and  concerning 
which  we  have  at  present  no  sound  basis  whatever  in  the  shape 
of  good  epidemiological  proof. 

5.  The  Possible  Means  of  preventing  Communicable  Disease 
Transmission  through  Milk,  and  their  Relative  Practi- 
cability. 

Enough  has  been  shown  to  demonstrate  that,  while  milk  is 
probably  not  as  great  a  factor  in  communicable  disease  trans- 
mission as  has  often  been  asserted,  it  is  none  the  less  a  very 
real  and  serious  element  in  the  problem  of  communicable  dis- 
ease prevention.  The  next  logical  step  is  to  eradicate  or  mini- 
mize this  danger.  One  effective  way  is  that  of  Japan  and  cer- 
tain other  Oriental  races,  —  not  to  use  the  milk  of  the  cow  for 
human  food.  The  great  benefits  that  we  derive  from  the  use 
of  cow's  milk  are  so  evident  that  such  a  procedure  is  unthink- 
able for  an  American  community. 

There  remains  the  problem  of  how  cow's  milk  may  be  made 
safe  as  far  as  communicable  diseases  are  concerned.  All  the 
numerous  expedients  and  measures  advocated  or  adopted 
throughout  the  civilized  world  with  this  end  in  view  can  be 
reduced  to  two  general  classifications. 

1.  Efforts  to  produce  a  milk  that  from  the  cow  to  the  ulti- 
mate consumer  presents  no  opportunity  for  infection. 

2.  Efforts  at  disinfection  of  the  milk  in  some  manner  by 
which  the  opportunities  for  subsequent  infection  would  be  re- 
duced to  a  minimum. 

In  the  pursuit  of  these  ends,  as  in  many  other  aspects  of  the 
milk  problem,  there  has  been  such  a  strong  bias  or  prejudice  on 
the  part  of  many  advocates  of  these  two  opposing  views  that 
it  has  rather  tended  to  obscure  the  fact  that  there  might  be 
a  very  distinct,  practical  and  sane  middle  course  available  be- 
tween the. two  extremes. 

The  advocates  of  the  cause  of  raw  milk  have  blindly  shut 
their  eyes  to  certain  ugly  facts  relative  to  milk  and  disease 


167 

transmission,  and  have  enormously  extended  the  prejudice  pre- 
viously existing  against  pasteurized  milk  by  such  sensational 
catchwords  and  slogans  as  "Pasteurized  milk  is  only  another 
name  for  rotten  milk."  The  advocates  of  sterilized  milk  in 
their  zeal  have  oftentimes  seemed  to  overlook  the  fundamental 
importance,  on  other  grounds  than  those  of  communicable  disease 
transmission,  of  having  milk  produced  and  handled  throughout, 
in  all  the  processes  from  cow  to  consumer,  in  the  cleanest  man- 
ner possible. 

The  ideal  of  the  raw  milk  advocate  is  in  a  phrase:  Milk 
from  absolutely  healthy  cows,  milked  and  handled  exclusively 
in  all  its  processes  of  collecting,  marketing  and  distributing  by 
individuals  known  to  be  in  perfect  health  and  incapable  of 
transmitting  disease,  who  at  the  same  time  observe  the  most 
rigid  precautions  as  to  personal  cleanliness  and  cleanliness  of 
utensils,  who  keep  the  milk  throughout  these  steps  at  a  very 
low  temperature,  and  who  deliver  it  in  the  shortest  possible 
time  to  the  consumer.  This  ideal  finds  its  nearest  approach 
to  realization  in  the  well-known  "certified  milks." 

But  every  year  of  accumulated  experience  has  demonstrated 
certain  obstacles  to  the  fulfillment  of  this  program.  The  chief 
ones  are  these :  — 

1.  That  only  a  very  small  percentage  of  milk  is  so  produced, 
because  such  milk  is  an  unusually  expensive  milk  to  put  on 
the  market,  and'  thus  becomes  impracticable  for  the  average 
consumer. 

2.  That  even  these  precautions  do  not  guarantee  the  con- 
sumer against  possible  infection  through  milk.  For  example, 
the  numerous  instances  in  which  a  certified  herd  has  most  un- 
expectedly been  found  to  have  become  extensively  infected  with 
tuberculosis,  or  such  an  occurrence  as  the  great  septic  sore 
throat  epidemic  of  Boston  and  vicinity  in  1911,  coming,  al- 
though not  from  a  certified  supply,  from  a  milk  supply  which 
was  guarded  by  most  elaborate  precautions  to  insure  a  high 
degree  of  cleanliness  and  freedom  from  infection. 

As  Rosenau  pithily  expresses  it,  "One  of  the  features  of 
special  interest  concerning  this  outbreak  was  that  this  milk 
has  always  been  a  particularly  clean,  fresh  and  satisfactory 
supply.  It  is  obtained  from  tuberculin-tested  cows,  under  con- 
stant veterinary  inspection,  and  the  milk  itself  is  subjected  to 


168 

daily  chemical  and  bacteriological  tests.  The  milk  is  bottled 
at  the  dairy,  the  bottles  sterilized,  and  all  reasonable  and  many 
extra  precautions  are  taken  to  insure  its  cleanliness  and  purity. 
It  emphasizes  the  lesson  that  raw  milk  is  apt  to  be  a  dangerous 
milk." 

In  fact,  a  careful  and  impartial  study  of  the  entire  question 
will  force  any  one  to  the  practical  conclusion  that  efficient  dis- 
infection is  our  only  certain  safeguard  against  infectious  dis- 
ease transmission  through  milk. 

Efficient  disinfection  can  be  conceivably  brought  about  by 
either  heat  or  chemical  action.  There  is  no  chemical  process 
that  we  can  discover  that  will  efficiently  disinfect  milk  without 
at  the  same  time  either  producing  chemical  changes  that  render 
the  milk  entirely  unfit  for  food,  or  else  will  introduce  substances 
into  the  milk,  as  formaldehyde,  that  are  in  themselves  dele- 
terious. 

Disinfection  by  heat  may  be  either  by  actual  boiling  or  by 
pasteurization.  Disinfection  by  boiling  produces  certain  chem- 
ical changes  in  the  composition  of  milk,  due  largely  to  the 
coagulating  of  the  milk  albumen,  which  materially  affects  the 
flavor.  Nevertheless,  it  is  the  procedure  of  choice  in  many 
European  countries. 

Since  it  has  now  been  firmly  established  that  pasteurization 
properly  carried  out  is  an  absolute  protection  against  patho- 
genic micro-organisms  that  may  have  accidentally  infected  milk, 
and  since  this  process,  carried  out  at  proper  temperatures  and 
with  proper  subsequent  handling  of  the  milk,  produces  no 
change  in  the  flavor  or  appearance,  and  no  chemical  changes 
of  any  practical  consequence,  pasteurization  has  become  firmly 
established  in  America  as  the  disinfection  process  of  choice. 

6.    Pasteurization  as  a  Means  of  Infectious  Disease  Prevention. 

Pasteurization  is  considered  in  another  section  from  various 
angles.  Here  our  only  interest  in  the  process  is  the  question 
of  its  efficacy  as  a  means  of  preventing  the  transmission  of 
communicable  diseases  through  milk. 

In  the  past  many  arguments  have  been  raised  against  pas- 
teurization. Unfortunately,  in  its  beginning  as  a  commercial 
practice  in  the  milk  industry  of  this  country,  pasteurization 


169 

received  a  bad  name  which  the  easily  demonstrable  benefits  of 
the  process  have  never  been  able  to  live  down. 

Pasteurization,  as  first  resorted  to  in  America,  was  in  spirit, 
if  not  in  law,  a  plain,  palpable  fraud.  The  process  was  origi- 
nally utilized  by  dealers  to  keep  dirty  milk  in  a  marketable  con- 
dition longer  than  could  otherwise  be  done.  This  naturally 
had  the  effect  of  aligning  health  authorities  against  the  process. 
It  was  many  years  before  sanitarians  generally  came  to  appre- 
ciate that  this  abuse  of  pasteurization  was  not  any  real  argu- 
ment against  the  benefits  of  pasteurization. 

Then  several  authorities  brought  forward  the  argument  that 
the  process  of  heating  milk  produced  certain  chemical  changes 
that  rendered  the  milk  less  suitable  for  infants'  diet,  and  that 
long-continued  use  of  pasteurized  milk  tended  to  produce  the 
disease  known  as  infantile  scurvy.  Several  years  of  heated  dis- 
cussions on  this  point  succeeded  in  effectually  settling  this  ob- 
jection by  proving  (1)  that  the  disease,  infantile  scurvy,  was 
comparatively  rare;  (2)  that  it  was  at  least  doubtful  whether 
pasteurization  of  the  milk  was  the  cause;  and  (3)  that  it  could 
be  both  prevented  and  cured  by  the  addition  of  fruit  juices, 
or  animal  or  vegetable  albumin,  in  simple  and  easily  digestible 
form,  to  the  child's  diet. 

With  this  objection  disposed  of  the  opponents  of  pasteuriza- 
tion took  refuge  in  the  claim  that  heating  milk  killed  the  "life" 
of  the  milk.  No  one  has  ever  been  able  to  demonstrate  just 
what  the  "life"  of  milk  is  in  the  sense  in  which  the  objection 
was  originally  used.  New  milk  has  a  certain  inhibitive  power 
over  bacterial  growth,  but  this  is  lost  after  eighteen  hours,  or, 
in  other  words,  some  time  before  the  ordinary  market  milk  of 
our  larger  cities  can  possibly  reach  the  market.  Milk  is  "  dead  " 
and  begins  to  decompose  from  the  moment  it  is  drawn  from 
the  udders,  —  sometimes  before  milking. 

There  are  several  so-called  enzymes,  or  ferments,  in  milk  the 
exact  nature  of  which  is  still  in  controversy,  but  none  of  these 
are  in  the  least  affected  by  the  temperature  to  which  milk  is 
heated  in  the  process  of  pasteurization  except  two  that,  so  far 
as  any  one  can  determine,  have  no  effect  upon  health. 

Another  objection  that  has  more  weight,  and  that  has  often 
been  raised  against  pasteurization,  is  that  the  process,  by  de- 


170 

stroying  the  lactic  acid  bacteria  which  normally  bring  about 
the  souring  of  milk,  destroys  "Nature's  danger  signals."  This 
argument  would  be  much  more  effective  if  it  were  not  for  the 
fact  that  pasteurization  at  the  temperature  recommended,  while 
it  kills  all  disease  germs,  does  not  destroy  all  the  souring  bac- 
teria. These  will  again  multiply,  and  hence  souring  is  only 
delayed,  not  prevented,  by  efficient  pasteurization  at  approved 
temperatures.  Nature  has  no  danger  signal  in  milk.  Sour  milk 
is  not  harmful.     Infected  milk  looks  and  tastes  well. 

The  great  and  original  objection  to  pasteurization  —  i.e.,  that 
it  promotes  dirty,  careless  methods  of  milk  production,  and 
leads  milk  handlers  to  believe  that  it  is  immaterial  how  much 
cow  dung  or  other  filth  gets  into  the  milk  —  is  still  the  one 
chiefly  used  by  the  opponents  of  pasteurization. 

This  entire  objection  falls  to  the  ground  if  once  the  sanitary 
prerequisite  is  firmly  established  that  milk  must  be  reasonably 
clean  to  be  eligible  to  pasteurization. 

When  the  positive  benefits  of  pasteurization  are  considered, 
the  evidence  is  so  overwhelming  as  to  admit  of  no  answer. 
Proper  pasteurization  kills  all  the  germs  of  the  communicable 
diseases  of  man  that  can  possibly  be  transmitted  through  milk. 
Pasteurized  milk  is  the  only  safe  milk. 

Pasteurized  milk  in  this  sense  means  milk  heated  to  not  less 
than  140  degrees,  nor  more  than  150  degrees  F.  (preferably 
145  degrees),  for  not  less  than  twenty  minutes  (preferably  one- 
half  hour),  then  cooled  quickly  and  kept  cool  and  free  from 
contamination  until  delivery  to  the  ultimate  consumer. 

Milk  so  treated  is  just  as  digestible,  just  as  nutritious  and 
just  as  palatable  as  the  raw  milk,  and  this  is  the  simplest, 
cheapest  and  best  method  of  making  milk  safe  from  the  danger 
of  transmitting  communicable  diseases.  The  certain  protection 
that  pasteurization  gives  against  infection  with  bovine  tubercle 
bacilli  in  itself  far  outweighs  all  the  economic,  esthetic  or  sani- 
tary objections  that  can  be  brought  against  the  process.  Fur- 
thermore, the  process  is,  as  Rosenau  says,  too  important  a 
health  matter  for  its  methods  of  carrying  out  to  be  left  under 
the  care  of  any  other  agency  than  that  of  the  health  authorities. 

No  one  denies  that,  except  when  pasteurization  is  carried  out 
in  the  final  container,  there  is  always  a  more  or  less  remote 
possibility  of  the  milk  being  reinfected,  before  it  reaches  the 


171 

ultimate  consumer,  from  direct  contact  by  a  convalescent  or  a 
chronic  disease  carrier.  With  this  limitation  clearly  understood, 
the  efficiency  of  pasteurization  as  a  disease-preventive  process 
becomes  the  more  remarkable  when  we  reflect  upon  the  as- 
tounding fact  that,  in  spite  of  the  hundreds  of  well-authenti- 
cated outbreaks  of  infectious  diseases  definitely  proven  to  have 
been  due  to  infected  milk,  and  in  spite  of  the  ever-increasing 
percentage  of  pasteurized  milk  placed  on  the  markets  of  the 
large  cities  of  this  country  in  the  past  twenty  years,  there  has 
never  yet  been  an  important  outbreak  of  a  communicable  disease 
that  could  be  attributed  to  a  pasteurized  milk  supply.  For  this 
statement  we  have  no  less  an  authority  than  Assistant  .Surgeon 
General  Trask  of  the  United  States  Public  Health  Service, 
under  whose  direct  personal  supervision  the  prevalence  of  com- 
municable diseases,  not  only  in  this  country  but  throughout 
the  world,  has  been  carefully  studied  for  many  years.  Writing 
under  a  very  recent  date,  Nov.  24,  1915,  in  response  to  an 
inquiry  on  this  point,  he  states:  "I  have  no  record  of  any 
epidemic  or  outbreak  of  any  size  that  was  milk-borne  on  a 
pasteurized  milk  supply." 

There  have  been  a  few  instances  in  which  an  outbreak  of 
communicable  diseases  has  occurred  on  a  milk  supply  which 
was  alleged  to  have  been  pasteurized,  or  on  the  route  of  a 
dealer  who  handled  both  pasteurized  and  unpasteurized  milk, 
from  which  the  impression  at  first  was  that  the  milk  came 
from  the  pasteurized  source.  In  every  instance  on  record  in 
which  such  an  occurrence  has  been  investigated  it  has  been 
found  that  no  real  pasteurization  of  the  milk  supply  had  been 
carried  out.  Either  pasteurization  was  claimed  when  it  had 
never  been  in  effect,  or  else  the  machinery  for  carrying  out 
the  pasteurization  was  at  the  time  of  the  outbreak  out  of  com- 
mission either  by  accident  or  neglect.  In  certain  of  these  in- 
stances, when  the  pasteurizing  machinery  got  out  of  order, 
there  was  at  least  a  strong  suspicion  that  the  pasteurizer  may 
have  acquired  only  a  sufficient  amount  of  heat  to  act  as  a 
bacterial  incubator  rather  than  as  a  bacterial  sterilizer.  The 
ever-present  possibility  of  such  accidents  occurring  in  pasteuri- 
zation, even  although  experience  has  proved  them  to  be  ex- 
tremely infrequent,  makes  the  need  for  efficient  governmental 
supervision  of  pasteurization  doubly  essential. 


172 


C.    MILK  AND  INFANT  MORTALITY. 

By  the  "infant  mortality  rate"  we  mean  the  number  of 
infants  under  one  year  old  who  die  as  compared  to  the  number 
born  during  that  year.  To  know  this  we  must  know  how  many 
are  born  and  how  many  die.  The  registration  of  both  births 
and  deaths  is  so  incomplete  in  the  United  States  that  these 
figures  are  not  obtainable  for  our  country  as  a  whole. 

The  Massachusetts  figures,  which  are  fairly  accurate,  are 
steadily  improving. 


Year. 


Rate  per 
1,000  born. 


1900, 
1905, 
1910, 
1914, 


156.7 
139.0 
135.6 
104.53 


In  Boston  the  figures  were,  in  1910,  126  per  1,000  born;  in 
1914,  102.23;  from  1909  through  1913  the  average  annual  rate 
was  120  per  1,000  born. 

In  foreign  countries  the  data  obtainable  are  not  quite  so 
recent. 


Country 

Scotland 

Norway,       ..... 

Sweden 

France, 

Austria 

Russia 

England 

Wales, 

New  Zealand,      .        .        .        . 


Years. 


Average 
Rate. 


1893-1902 
1893-1902 
1893-1902 
1893-1902 
1895-1900 
1890-99, 

1901-05, 

[  1910, 

1911, 

1 1912, 


127 
94 
99 
158 
227 
272 

138 

68 
56 
51 


Our  Massachusetts  rate  is  not  by  any  means  the  highest  in 
the  world,  but  it  cannot  be  considered  in  the  same  class  with 


173 


that  of  New  Zealand,  the  lowest.  We  pride  ourselves  on  our 
knowledge  of  science  and  scientific  methods,  yet  in  the  matter 
of  the  reduction  of  infant  mortality  we  are  not  even  in  the 
advance  guard  of  the  nations. 

The  causes  of  infant  mortality  are  many  and  complicated. 
The  following  table  shows  the  relative  importance  of  the  prin- 
cipal causes  as  stated  by  Dr.  Emmett  Holt  of  New  York,  an 
eminent  authority,  by  the  Maryland  State  Board  of  Health, 
and  by  Drs.  Koehler  and  Drake  of  Chicago. 


Holt. 


Maryland 
State  Board 
of  Health. 


Koehler  and 
Drake. 


Percentages  due  to:  — ■ 
Diarrhceal  diseases, 
Congenital  defects  and  childbirth, 
Pneumonia,  bronchitis,  influenza, 
Acute  contagia,         .        .        .        . 

Tuberculosis, 

Venereal  diseases,     . 
All  other  causes, 


28.0 
31.3 
18.5 
5.4 
2.0 
1.2 
13.6 


38.5 
17.1 
14.7 
5.0 
2.5 


39.8 
24.0 
20.6 
3.2 
1.6 
1.3 
4.8 


Cow's  milk  as  an  infant  food  might  enter  prominently  into 
the  following  of  these  causes:  Diarrhceal  diseases,  acute  con- 
tagia and  tuberculosis. 

Its  significance  in  the  acute  contagia  and  in  tuberculosis  are 
considered  in  another  portion  of  this  report. 

According  to  the  majority  of  authorities,  failure  on  the  part 
of  mothers  to  provide  breast  milk  for  their  children  appears  to 
be  on  the  increase  throughout  the  civilized  world. 

Spargo  says : — 

The  modern  mother  is  growing  more  and  more  unable  to  nurse  her  child 
at  her  breast.  For  some  subtle  reason  this  function  of  maternity  is  being 
atrophied  in  civilized  women;  and  the  higher  their  civilization  the  less 
able  are  they  to  suckle  their  children.  With  the  vast  majority  of  women 
who  find  themselves  unable  to  discharge  this  important  maternal  duty 
the  trouble  is  not  social  or  economic  but  physiological. 

Dr.  Holt  tells  us  that  among  the  well-to-do  and  cultured 
mothers  not  more  than  25  per  cent,  of  those  who  have  earnestly 
and  intelligently  attempted  to  nurse  have  succeeded  in  doing 
so  for  as  long  as  three  months.     Among  the  poorer  classes  in 


174 


our  cities  there  is  also  a  marked  decline  in  nursing  ability,  al- 
though not  yet  to  the  same  degree  as  among  those  higher  in 
the  social  scale. 

On  the  other  hand,  according  to  Dr.  Herman  Schwartz  of 
New  York,  based  on  observation  of  1,500  babies,  96  per  cent, 
of  the  mothers  were  able  to  nurse  their  babies  for  one  month 
or  less.  He  says:  "This  proves  very  conclusively  that  if  care 
is  taken  from  the  very  start  most  women  can  do  something 
toward  nursing  their  children." 

With  every  failure  in  the  ability  of  a  mother  to  nurse  her 
child  comes  the  demand  for  a  substitute  food  for  the  infant. 
No  ideal  substitute  has  been  found.  Many  milks  have  been 
used  which  approximate  more  or  less  closely  to  human  milk 
in  composition.  Because  of  the  quantity  needed,  because  of 
the  establishment  of  the  dairy  industry  in  this  country  and 
its  consequent  availability,  because  it  can  be  modified  com- 
paratively readily  to  a  close  approximation  to  human  milk, 
cow's  milk  has  been  and  will  be  our  main  standby.  It  then 
follows  that  if  we  are  to  provide  cow's  milk  as  a  substitute 
food  for  our  infants  we  must  see  to  it  that  this  substitute 
saves  as  many  infants'  lives  as  possible  and  kills  as  few  as 
possible. 

The  composition  of  human  milk  differs  from  cow's  milk,  as 
follows :  — 


Protein. 


Fat. 


Milk  Sugar. 


Mineral 
Matter. 


Human  milk, 
Cqw's  milk, 


1.6 
3.2 


3.4 

3.7 


6.1 
4.9 


6.20 
0.75 


The  greatest  difference  is  in  the  protein  content.  Protein  is 
the  muscle-building  element.  In  cow's  milk  it  is  present  in 
a  greater  quantity  in  proportion  to  the  other  elements  than 
the  human  body  requires.  To  get  a  sufficient  amount  of  milk 
sugar  from  unmodified  cow's  milk  a  large  excess  of  protein  jand 
a  lesser  excess  of  fats  would  be  taken.  On  the  other  hand,  to 
secure  proper  amounts  of  protein  would  be  to  take  an  insuf- 
ficient supply  of  fats  and  a  still  less  sufficient  supply  of  milk 
sugar.    Again,  the  protein  in  cow's  milk  is  of  a  different  chem- 


175 

ical  composition  from  that  in  human  milk;  it  forms  a  tougher 
curd  and  is  more  resistant  to  digestion.  The  fat  in  cow's  milk 
is  in  larger  globules  and  has  a  higher  melting  point  than  the 
fat  in  human  milk.  Raw,  unmodified  cow's  milk  is  an  unnat- 
ural and  badly  balanced  food  for  infants.  By  proper  modifi- 
cation the  proportion  of  the  different  elements  can  be  brought 
to  correspond  to  the  proportions  in  human  milk,  but  the  chem- 
ical variations  in  the  proteins  and  the  fats  cannot  be  brought 
to  correspond. 

Human  milk  as  administered  by  breast  feeding  requires  no 
intermediary  handling  or  storage,  and  is  taken  into  the  child's 
stomach  with  a  minimum  of  contamination  and  of  bacterial 
content.  Cow's  milk  must  be  handled  by  milkers,  transporta- 
tion agents,  dealers  and  mothers  or  attendants  with  ever- 
present  opportunities  for  contamination  by  dirt  and  disease 
germs.  It  must  be  stored  in  containers,  and  is  more  or  less  • 
often  transferred  from  one  container  to  another  with  the  at- 
tendant dangers  from  dirty  vessels  or  diseased  handlers.  The 
necessary  time  elapsing  between  milking  and  feeding  gives  great 
opportunity  for  increase  in  the  bacterial  content.  All  these 
factors  occurring  at  all  stages  of  the  route  of  the  milk  from 
the  cow's  udder  to  the  baby's  stomach  —  on  the  farm,  on  the 
road,  in  the  distributor's  hands  and  in  the  home  —  furnish 
opportunities  to  render  a  clean  milk  dirty,  a  pure  milk  infected. 

Milk,  whether  from  the  cow  or  the  woman,  is  produced  at 
body  temperature.  Both,  as  secreted,  are  naturally  sterile. 
Both  may  be  infected  in  the  process  of  milking.  Bacteria  mul- 
tiply but  little  at  a  low  temperature,  but  milk,  at  summer  tem- 
perature, becomes  an  excellent  culture  medium  for  many  vari- 
eties. The  question  whether  the  germs  of  communicable  diseases 
of  man  may  multiply  in  milk  to  any  great  extent  is  still  dis- 
puted. .  However,  it  is  not  disputed  that  disease  germs  live  for 
varying  but  considerable  periods  of  time  in  milk,  when  once 
introduced,  and  are  transmitted  by  it  to  their  natural  environ- 
ment, the  human  body,  and  there  multiply  and  produce  then- 
specific  disease. 

Cow's  milk,  unless  properly  cooled  and  kept  cool  during  the 
time  elapsing  between  production  and  consumption,  becomes 
loaded  with  bacteria   and  their  products.     Reasonable  protec- 


176 

tion,  therefore,  demands  this  prompt  cooling  and  continuous 
holding  at  the  safe  temperature.    , 

Dirt,  with  its  accompanying  dangerous  chemical  and  bac- 
terial elements,  may  be  introduced  into  the  milk  at  any  or  all 
stages  of  its  journey,  —  from  dirty  udders,  teats  and  flanks  of 
the  cow;  dirty  hands  of  the  milker;  dirty  methods  of  milking; 
dirty  stables  and  pails;  dirty  washing  water;  dirty  milk  ma- 
chinery; dirty  distributors,  wagons  and  bottles;  dirty  utensils 
in  the  home;  dirty  attendants;  dirty  mouths  in  the  babies, 
etc. 

Cow's  milk  for  infants  is  a  primarily  ill-suited  food  that  is 
in  constant  and  continuous  danger  of  becoming  a  positively 
toxic  food  at  every  stage  of  its  existence  as  milk.  If,  however, 
the  natural  supply  of  infant  food  fails,  something  must  be  pro- 
vided in  order  to  prevent  starvation  and  death,  and  it  is  our 
ofHce  to  see  to  it  that  the  substitute  is  as  little  toxic  as  possible. 

The  Place  of  Cow's  Milk  as  a  Cause  of  Infantile  Diarrhoea. 

In  wholly  breast-fed  babies  it  can  have  no  effect;  in  partly  or 
wholly  bottle-fed  babies  it  is  of  primary  importance. 

The  proportion  of  breast-fed  to  bottle-fed  babies  in  our  in- 
fant population  is  an  unknown  quantity. 

It  is  stated  that  in  Norway  and  Sweden  nearly  all  infants 
are  breast  fed;  in  Scotland  80  to  85  per  cent,  are  breast  fed; 
in  France  there  is  little  breast  feeding;  in  Russia  little  breast 
feeding;  in  Austria  breast  feeding  is  predominant  in  the  upper 
classes,  artificial  in  the  lower;  no  definite  statements  regarding 
England  and  Wales  could  be  found,  but  all  comment  indicated 
a  large  percentage  of  bottle  feeding;  in  this  country  the  general 
impression  is  that  breast  feeding  is  steadily  declining. 

In  Chicago,  during  July,  August  and  September,  1911,  ac- 
cording to  reports  from  visiting  nurses,  there  were,  among  the 
infants  visited  by  them,  15,861  breast-fed  infants  and  5,477 
bottle-fed  infants.  Dr.  W.  H.  Davis  states  that  in  Boston,  in 
1911,  out  of  every  100  babies  68  were  breast  fed  and  32  were 
bottle  fed,  and  that  of  the  621  deaths  of  infants  from  diarrhoea 
and  enteritis  in  Boston  during  the  same  period  87  were  breast 
fed  and  534  were  bottle  fed.  In  other  words,  6  bottle-fed  in- 
fants died  of  intestinal  trouble  to  1  breast  fed,  and  there  were 


177 

not  half  as  many  bottle-fed  babies  in  the  city  as  there  were 
breast  fed. 

Authorities  the  world  over  agree  almost  without  exception 
that  the  mortality  of  bottle-fed  infants  is  frightfully  in  excess 
of  the  mortality  of  breast-fed  infants,  and  that  this  excess  of 
mortality  is  in  great  measure  due  to  intestinal  disturbances  or 
communicable  diseases  caused  by  contaminated  or  infected 
milk. 

The  health  of  the  cow  is  the  first  factor  in  pure  milk  pro- 
duction. No  one  would  expect  to  get  a  milk  absolutely  free 
from  dangerous  possibilities  from  a  sick  cow.  Of  about  the 
same  importance  is  the  health  of  the  person  taking  care  of  the 
cow.  Our  records  of  communicable  diseases,  showing  how  in 
many  instances  a  case  of  disease  at  the  dairy  is  spread  along 
the  milk  route  in  epidemic  form,  prove  the  actuality  of  this 
danger. 

Cow  dung  in  the  milk  is  at  least  undesirable  from  the  stand- 
point of  the  average  consumer.  Many  of  our  best  pediatricians 
believe  that  it  is  a  positive  danger.  An  uncleaned  cow  or  an 
uncleaned  milker,  an  uncleaned  stable  or  a  stable  cleaned  at 
the  time  of  milking,  uncleanly  methods  of  milking,  straining, 
cooling  or  storing  milk,  —  all  give  frequent  opportunities  for 
this  contamination. 

The  use  of  simple  and  easily  learned,  clean  methods  protect 
milk  from  dirt  to  an  astonishing  degree;  clean  cows,  clean 
stables,  clean  milkers  and  the  small-top  pail  work  wonders. 

The  dirt  that  does  the  most  harm  in  milk  is  bacterial.  Milk 
at  a  temperature  approaching  body  heat  is  a  very  perfect  cul- 
ture ground  for  many  bacteria.  Counts  of  bacteria  content 
show  a  steady  and  extraordinary  rapid  increase  in  the  number 
of  bacteria  in  milk  that  is  held  warm,  and  this  increase  is 
measured  largely  by  the  length  of  time  it  is  so  held.  On  the 
other  hand,  milk  at  50°  F.  or  lower  is  not  a  good  culture 
medium,  and  milk  that  is  cooled  immediately  after  milking  to 
that  temperature  and  held  at  that  temperature  can  be  stored 
for  a  comparatively  long  time  without  showing  great  increase 
in  its  bacterial  content. 

In  the  milk  business  proper  cooling  of  the  milk  and  holding 
it  cold  is  not  a  complicated  process,  but  like  many  other  simple 


178 

processes  it  is  difficult  of  execution  because  it  has  to  be  per- 
fectly carried  out  to  insure  safety.  Failure  to  cool  immediately 
and  to  hold  cold  constantly  and  continuously  spells  bacterial 
growth.  To  be  safe  it  must  be  held  cold  through  the  whole 
journey  from  the  cow  to  the  baby,  in  the  dairy,  during  collec- 
tion and  transportation,  at  the  dealer's,  during  distribution  and 
at  the  home  before  use.  It  is  a  long  chain,  and,  like  all  chains, 
if  a  weak  link  develops  it  will  break  there  and  be  worse  than 
useless. 

Of  late  years  there  has  been  much  legislative  discussion  aimed 
at  the  control  of  the  production  of  milk.  Cattle  and  dairies 
are  more  or  less  thoroughly  inspected,  and  milk  dealers  adver- 
tise and  show  to  the  public  as  well  as  to  the  inspectors  the 
cleanliness  and  safety  of  their  methods  of  handling  milk.  By 
constant  watchfulness  a  certain  measure  of  protection  is  being 
secured  up  to  the  point  of  delivery  of  the  milk  at  the  home. 
After  that  point  is  reached  the  elements  of  human  ignorance, 
poverty  and  carelessness  come  into  the  question  where  they 
are  beyond  the  control  of  legal  remedial  measures.  That  a 
very  large  proportion  of  the  contamination  of  milk  at  the 
present  date  occurs  in  the  home  seems  to  be  the  common  con- 
clusion of  investigators. 

Mr.  W.  E.  Kreusi,  of  the  Milk  and  Baby  Hygiene  Associa- 
tion of  Boston,  testified  in  1910  as  follows:  — 

The  committee  regards  the  milk  situation  very  much  better  with 
respect  to  conditions  at  the  producer's  end,  and  very  much  better  as  to 
conditions  in  the  contractors'  and  peddlers'  hands,  than  in  the  hands  of 
the  ordinary  consumer. 

The  effort  to  save  babies'  lives  through  baby  feeding  and 
milk  stations  has  gained  enormous  headway,  and  has  produced 
very  definite  and  highly  satisfactory  results.  As  these  organi- 
zations were  originally  instituted  their  object  was  to  furnish  a 
pure,  clean  milk  as  a  food  for  infants.  A  notable  example  of 
this  was  the  establishment  of  milk  depots  in  New  York  through 
the  philanthropy  of  Mr.  Nathan  Strauss.  It  soon  became  evi- 
dent that  this  did  not  solve  the  problem.  As  one  of  Dr.  Price's 
nurses  in  Detroit  put  it,  "To  successfully  combine  milk  with 
a  baby  you  must  take  care  of  the  baby  as  well  as  the  milk." 


179 

The  home  conditions,  the  care  of  the  milk  at  home,  and  the 
general  hygiene  of  the  baby  were  evidently  as  important  or 
even  more  important  than  the  exceptional  original  purity  of 
the  milk.  The  follow-up  nurse  was  introduced,  who  went  to 
the  home,  advised  sanitary  improvements  and  taught  the  igno- 
rant mother  the  simplest  principles  of  the  hygienic  care  of  the 
baby  as  well  as  of  the  milk.  Dr.  Price  of  Detroit  reversed  his 
infant  mortality  rates  —  made  them  lower  in  the  hot  months 
than  they  had  been  in  the  cold  —  by  the  use  of  nurses  alone, 
not  nurses  combined  with  milk  stations. 

In  the  past  the  cause  of  summer  diarrhoeas  in  infants  has 
been  almost  always  charged  up  to  bad  milk.  It  was  admitted 
that  other  factors  entered  in,  but  it  was  believed  that  they 
did  so  to  so  small  an  extent  as  to  be  comparatively  negligible. 
Prompted  by  the  results  obtained  by  the  work  of  the  visiting 
nurse,  studies  are  being  made  that  are  showing  the  unexpect- 
edly large  measure  of  importance  of  factors  other  than  sanitary 
milk. 

Dr.  Arthur  Newsholme,  an  eminent  English  sanitarian,  in  a 
study  of  1,259  infants  during  an  epidemic  of  infantile  diarrhoea, 
found  that  artificial  feeding  was  the  habit,  either  wholly  or  in 
part,  with  the  large  majority  of  cases  of  the  disease,  showing 
the  value  of  breast  feeding;  but  also  he  found  that  babies  fed 
on  condensed  milk  were  twice  as  susceptible  to  the  disease  as 
were  those  fed  on  fresh  cow's  milk,  showing  that  it  was  rather 
the  artificiality  of  the  feeding  than  the  cow's  milk  as  a  food 
that  was  responsible.  Also  from  this  series  it  might  well  be 
argued  that  cow's  milk  was  the  best  substitute  food  if  a  sub- 
stitute must  be  used. 

Prof.  C.  E.  A.  Winslow  of  New  York  finds  that,  in  the  case 
of  infants,  bad  ventilation  and  indoor  heat  are  almost  as  im- 
portant causative  factors  in  diarrhceal  as  they  are  in  respiratory 
diseases;  that  heat  alone  has  a  marked  effect  on  the  baby. 
In  a  series  of  infants  who  were  either  breast  fed  or  fed  from 
bottles  under  the  best  conditions  he  found  that  while  80  per 
cent,  of  them  did  well  during  the  winter,  only  60  per  cent,  did 
well  during  the  hot  months,  showing  the  important  definite 
effect  of  heat  alone. 

Holt  and  Park  say:  — 


180 

The  depressing  effects  of  great  atmospheric  heat,  i.e.,  a  temperature 
in  the  neighborhood  of  90°  F.  or  over,  were  very  marked  in  all  infants 
no  matter  what  their  food.  Those  that  were  ill  were  almost  invariably 
made  worse,  and  many  who  were  previously  well  became  ill. 

Dr.  J.  W.  Shereschewsky  of  the  United  States  Public  Health 
Service,  in  discussing  the  effects  of  heat  on  infant  mortality, 
concludes  that  the  action  of  heat  as  a  direct  cause  has  been 
greatly  underestimated;  that  it  is  the  indoor  heat  common  in 
poor  housing  conditions  that  is  responsible;  that  the  respon- 
sibility of  dirty  and  stale  milk  has  been  overestimated,  although 
breast  feeding  must  still  be  regarded  as  a  most,  if  not  the  most, 
important  preventive  of  the  summer  deaths  of  infants;  that 
future  activities  for  the  prevention  of  infant  mortality  must 
concentrate  themselves  to  a  greater  extent  on  the  improvement 
of  housing  conditions,  and  on  education  regarding  the  proper 
care  of  babies  in  the  summer. 

Infants  are  delicate  machines.  It  is  not  necessary  that  they 
should  be  bottle  fed  to  endow  them  with  a  high  death  rate. 
Incomplete  development,  inherited  constitutional  weaknesses  or 
disease,  excessive  heat,  high  humidity,  poor  ventilation,  im- 
proper clothes,  accidents  and  the  various  communicable  dis- 
eases are  all  factors  in  it. 

The  experience  of  this  State  seems  to  be  that  the  causes  of 
infant  mortality  cannot  be  charged  in  the  majority  of  cases  to 
the  condition  of  the  milk  supply  as  delivered  at  the  door.  Un- 
questionably this  is  the  cause  in  many  cases  of  death,  but  not 
in  a  preponderance  of  them. 

Dr.  Gerstenberger  of  Cleveland,  after  stating  that  300,000 
under  one  year  of  age  die  yearly  in  the  United  States,  says  he 
wishes  to  call  your  attention  emphatically  to  the  fact  that  at 
least  50  per  cent,  of  these  are  dying  without  any  real  cause, 
simply  from  ignorance  of  the  parents,  their  advisors,  —  they 
are  the  physicians  and  nurses,  —  and  from  ignorance  of  the 
public  at  large.  Most  parents,  especially  the  more  poorly  situ- 
ated, have  but  the  slightest  conception  of  the  proper  hygiene 
of  the  child  and  its  surroundings.  The  big  bulk  of  advisors  of 
the  parents  —  the  physicians  and  nurses  —  are  too  ignorant  to 
train  and  advise  parents  "because  not  especially  trained  for 
this."     The  public  does  not  appreciate  how  many  lives  are 


181 

lost,  and  does  not  know  that  the  power  to  remedy  the  condi- 
tions at  fault  lies  in  its  hands,  and  its  hands  alone. 

Dr.  Newsholme  states  that  while  infections  resulting  in  in- 
fantile diarrhoea  are  possibly  introduced  on  the  farm,  in  his 
opinion  the  majority  are  of  human  origin,  and  closes  his  sum- 
mary with  the  following :  — 

In  balancing  up  the  above  facts  and  considerations  I  have  no  hesitation 
in  adhering  to  the  opinion  stated  in  many  of  my  past  annual  reports,  — 
that  diarrhoea  is  mainly  due  to  domestic  infection. 

On  the  other  hand,  many  believe  with  Dr.  Henry  L.  Coit 
of  Newark,  N.  J.,  that  our  reliance  should  be  placed  on  the 
production  of  a  safe,  raw,  "certified"  milk,  controlling  it  by 
flawless  inspection  from  the  cow  to  the  consumer;  that  if  we 
provide  an  absolutely  safe  milk  to  begin  with  we  minimize  the 
dangers  in  the  use  of  cow's  milk  as  an  infant  food. 

What  are  the  remedies? 

1.  We  must  insure  a  clean,  safe  milk. 

2.  We  must  educate  mothers. 

1.    Insuring  a  Clean,  Safe  Milk. 

Efforts  to  secure  such  a  milk  supply  have  occupied  the  Legis- 
lature a  goodly  amount  of  time  in  the  past.  It  is  obvious  that 
hygienic  conditions  in  the  dairy,  in  transportation  and  in  the 
sale  and  delivery  of  milk  can  be  secured  only  by  constant 
supervision.  Where  a  reasonably  safe  line  between  expense 
and  results  can  be  drawn  can  only  be  determined  by  experi- 
ence. It  will  be  best  to  err  on  the  side  of  safety.  Since  the 
health  of  the  milk  handlers  is  a  matter  of  importance  in  the 
transmission  of  communicable  diseases,  and  since  many  of  these 
diseases  are  transmissible  before  identifiable  symptoms  appear 
in  the  patient,  it  follows  that  the  most  carefully  inspected, 
"certified"  milk' may  become  infected  in  spite  of  the  most 
faithful  and  detailed  inspection.  As  long  as  human  beings  are 
fallible,  so  long  will  contaminating  accidents  be  possible  at  any 
point  between  the  cow  and  the  final  consumer. 

Heating  milk  to  the  boiling  point,  sterilizing  it,  frees  it  from 
live  bacteria.     In  Amsterdam,  Holland,   the   entire   supply  of 


182 

the  city  is  boiled  to  protect  against  epidemics.  In  Europe,  in 
general,  milk  is  cooked.  Advocates  of  this  system  extol  the 
absolute  freedom  from  bacteria  and  the  consequent  safety  of 
the  milk.  Opponents  argue  that  there  is  a  chemical  change 
resulting  from  the  heat  that  changes  the  digestibility  of  the 
milk  and  causes  digestive  disturbances  in  the  consumer,  and, 
in  particular,  results  in  infantile  scurvy.  Many  experiments 
by  European  and  American  investigators  seem  to  show  that 
this  viewpoint  is  not  supported  by  fact  to  a  demonstrable 
degree.  This  process  does  change  the  taste  of  the  milk,  pleas- 
antly to  some  and  unpleasantly  to  others. 

Heating  milk  to  between  140°  and  167°  F.,  and  holding  it  at 
that  temperature  for  twenty  minutes,  kills  the  germs  of  all 
the  communicable  diseases  so  far  as  we  know  them.  This 
process  is  known  as  "pasteurization."  The  efficacy  of  pas- 
teurization in  the  control  of  milk-borne  epidemics  has  been 
frequently  proved  in  the  State.  It  certainly  does  kill  the  dis- 
ease-producing bacteria,  if  properly  performed.  Advocates  of 
pasteurization  base  their  arguments  on  the  results  obtained  in 
the  reduction  of  infant  mortality  following  the  institution  of 
the  process.  Opponents  state  that  the  rendering  milk  safe  by 
this  process  puts  old,  stale,  decayed  milk  on  an  even  footing, 
from  the  standpoint  of  salability,  with  Clean,  fresh  milk,  and 
there  is  no  escaping  the  conclusion  that,  in  part  at  least,  they 
are  justified.  They  also  argue  that,  just  as  in  "cooked"  milk, 
there  is  the  possibility  of  resultant  scurvy  in  the  consumer. 
In  this  particular  their  arguments  appear  to  be  unsubstantiated. 

In  the  Transactions  of  the  Second  International  Congress  on 
the  Milk  Industry,  held  in  Paris  in  1905,  Dr.  H.  de  Rothschild, 
speaking  of  infantile  scurvy,  refers  to  objections  raised  to  pas- 
teurization on  the  ground  that  it  causes  this  disease.  He  says 
that  a  careful  study  made  by  him  for  ten  years  showed  only 
23  cases  in  the  whole  of  France;  and  that  he  is  forced  to  con- 
clude that  if  such  a  process  is  effective  in  the  reduction  of 
gastroenteritis,  tuberculosis  and  typhoid  fever,  to  base  an  ob- 
jection to  its  use  on  the  ground  that  it  may  cause  a  disease 
that  has  occurred  but  23  times  in  ten  years  is  not  valid. 

One  or  more  of  these  three  methods  of  securing  a  clean,  pure 
milk  are  used  in  communities  the  world  over  with  success  that 
is  more  or  less  perfect.    The  majority  of  observers  seem  to  favor 


183 

a  combination  of  thorough  inspection  followed  by  pasteuriza- 
tion, —  not  overlooking  or  belittling  the  immense  advantage 
of  clean  production  and  distribution,  but  augmenting  that  by 
the  additional  safeguard  of  pasteurization. 

Dr.  Henry  Helmholtz  of  Chicago  says  on  this  subject:  — 

There  are  those  who  would  prevent  all  infant  mortality  if  they  could 
only  feed  all  children  of  the  tenements  a  pure,  clean,  raw  milk.  There 
are  those  who  would  accomplish  the  same  end  by  feeding  them,  one  and 
all,  pasteurized  milk.  In  each  case  they  do  not  realize  that  infant  mortal- 
ity is  a  very  complex  problem,  and  that  either  one  of  these  things  is  only 
a  small  factor,  and  that  when  it  comes  to  the  feeding  end  of  the  problem 
perhaps  the  most  important  thing  is  not  so  much  what  is  fed  as  the  way 
in  which  it  is  fed. 

2.    Educating  Mothers. 

As  pointed  out  earlier,  the  contamination  of  the  milk  after 
delivery  at  the  home  is  perhaps  our  most  common  present 
source  of  danger.  No  matter  how  pure  and  clean  the  supply, 
dirt  added  there  renders  the  article  just  as  deleterious  as  dirt 
added  at  any  point  previously,  allowing  only  for  the  length 
of  time  between  pollution  and  use  and  its  proportionate  bac- 
terial growth.  The  mother  who  lets  milk  stand  in  a  dirty 
pitcher  in  the  sun  for  an  hour  or  two,  then  pours  it  into  a 
stale  pan  and  puts  it,  uncovered,  into  a  half-cooled  refrigerator 
full  of  stale  articles  of  food,  and  who  goes  through  the  long 
list  of  dirty  methods  of  getting  it  into  a  baby's  uncleaned 
mouth,  is  just  as  crassly  ignorant  or  as  criminally  careless  as 
the  unhealthy  producer  who  milks  unhealthy  and  uncleaned 
cows  in  a  dirty  stable  into  dirty  utensils,  and  the  results  to 
the  infant  are  just  as  fatal. 

We  have  laws  and  regulations  which,  according  to  our  ex- 
perience, are  controlling  the  producer  and  the  dealer  to  some 
degree,  —  many  believe  to  a  large  degree,  —  but  we  have  no 
way  of  reaching  by  legal  means  the  consciously,  or  uncon- 
sciously, dirty  woman  in  her  home.  The  dirtiness  is  both 
visible  and  invisible,  whether  added  by  the  producer  or  the 
housekeeper.  There  is  no  excuse  for  visible  dirt  in  either  case; 
it  can  be  explained  in  only  one  way.  Bacteriological  dirt  is 
not  visible,  and  its  presence  may  be  due  either  to  ignorance, 
to  carelessness  or  to  a  wilful  disregard  of  teaching.  Women 
do  not  want  their  babies  to  die.     When  they  are  told  where 


184 

the  danger  lies,  and  really  believe  that  it  does  lie  there, 
there  is  not  much  wilful  disregard  left.  If  the  teacher  can 
check  up  how  well  her  instructions  are  being  carried  out  there 
is  not  much  room  for  carelessness.  Most  women  with  a  young 
baby  have  not  much  time  to  go  to  school,  nor  can  they  leave 
their  babies  unattended  while  they  do;  therefore  the  school 
must  be  made  to  come  to  them. 

So  far  we  have  evolved  just  one  agency  that  answers  these 
requirements,  —  the  visiting  nurse.  The  mother  believes  that 
the  nurse  knows  what  she  is  talking  about;  that  she  is  not 
visiting  her  to  make  capital  out  of  her,  but  to  protect  her 
baby;  that  she  is  a  woman  and  cannot  help  loving  babies;  in 
short,  she  gives  her  her  complete  confidence.  The  nurse's  visits 
are  frequent,  and  the  mother  does  not  have  much  time  to  get 
rankly  careless  between  them.  At  each  visit  the  nurse  brings 
the  school  to  the  home  in  lessons  graded  and  fitted  to  the  per- 
sonal intellectual  capacity  of  the  woman. 

Combine  this  system  of  education  with  a  pure  milk  supply 
and  we  have  the  framework  of  our  present-day  methods  in  the 
attempt  to  reduce  our  infant  mortality  rate. 

Associations  and  institutions  all  over  the  civilized  world  are 
using  this  method  with  a  success  so  universal  and  so  generally 
appreciated  that  no  statistics  are  offered. 

Summary. 

The  infant  mortality  rate  is  still  higher  than  it  should  be,  — 
higher  than  the  investigators  feel  is  inevitable.  A  still  unde- 
termined part  of  this  excess  is  due  to  the  quality  of  infant's 
food  and  the  method  of  its  administration.  Breast  milk  is  the 
natural  food  for  the  infant.  When  this  maternal  function  fails 
a  substitute  food  is  required.  Modified  cow's  milk  is  the  com- 
mon substitute,  although  it  has  inherent  qualities  that  make 
it  an  imperfect  food  for  infants.  The  supply  for  our  cities 
must  be  brought  from  a  distance.  It  may  become  polluted  at 
any  time  between  its  secretion  in  the  cow's  udder  and  its  diges- 
tion in  the  stomach  of  the  infant.  To  make  it  reasonably  safe 
it  should  be  controlled  by  inspection  and  pasteurization  up  to 
the  point  of  delivery  at  the  home,  and  controlled  after  delivery 
by  the  education  of  the  mother  in  hygienic  methods. 


185 


D.    THE  NUTRITIONAL  VALUE  OF  MILK. 

After  trying  to  digest  the  mass  of  conflicting  evidence  in  the 
various  aspects  of  the  danger  to  the  public  health  from  milk, 
—  a  subject  that  from  the  nature  of  the  evidence  obtainable 
must  be  insusceptible  of  definite  proof,  —  it  is  a  pleasure  to 
approach  a  subject  in  which  some  definite  facts  can  be  stated. 
Further,  it  appears  to  us  that,  especially  in  popular  discussions 
of  the  milk  question,  the  emphasis  has  been  generally  laid  on 
these  dangers,  passing  over  the  enormous  value  of  milk  to  the 
human  race  with  a  very  light  touch;  therefore  it  is  doubly  a 
satisfaction  to  register  our  appreciation  of  the  unique  place 
held  by  this  sterling  and  indispensable  food. 
v'The  universal  use  of  milk  as  an  ingredient  of  a  large  pro- 
portion of  the  products  of  the  kitchen  has  perhaps  made  us 
lose  sight  of  its  prime  individual  value  as  a  complete  food  in 
itself,  and  of  the  fact  that  it  is  the  only  single  article  of  our 
foodstuffs  which  is  so  constituted,  and  is  in  itself  so  balanced 
and  complete  a  ration,  that  human  life  can  be  sustained  on 
it  alone  for  a  long  period.  For  infants  human  milk  is  the  'per- 
fect food.  As  referred  to  elsewhere  in  this  report,  a  substitute 
food  is  frequently  called  for  because  of  the  failure  of  the  mater- 
nal supply.  As  also  stated,  for  economic  reasons  and  because 
of  custom,  cow's  milk  is  the  usual  substitute  in  this  country. 
Cow's  milk  and  human  milk  are  near  enough  alike  in  the  pro- 
portion of  their  constituents  so  that  by  simple  means  —  so 
simple  that  a  person  of  average  mentality  can  understand  and 
carry  them  out  —  cow's  milk  can  be  made  sufficiently  digestible 
food  for  the  average  infant.  This  is  particularly  true  in  cases 
where  the  mother  has  been  able  to  nurse  her  child  long  enough 
to  get  him  well  started  in  life.  With  many  infants,  however, 
the  chemical  differences  between  the  milk  of  the  cow  and  of 
the  woman  render  cow's  milk,  however  modified,  an  unsuitable 
food  for  them. 

As  compared  with  the  corresponding  constituents  in  human 
milk,  the  proteins  in  cow's  milk  are  more  abundant  and  form 
a  tougher,  less  flocculent  cord,  which  is  less  easily  penetrated 
and  dissolves  more  slowly  in  the  digestive  fluids.  The  propor- 
tion of  casein  in  the  proteins  is  larger,   and  of  lactalbumin, 


186 

smaller.  The  fats  in  cow's  milk  occur  in  larger  globules  and 
have  a  higher  melting  point.  The  sugar  in  cow's  milk  is  less 
in  amount,  but  identical  in  composition.  The  salts  in  cow's 
milk  are  more  plentiful,  and  are  those  of  lime  and  magnesium 
instead  of  those  of  potassium  and  sodium.  Further,  while  both 
are  alkaline  when  drawn,  the  cow's  milk  soon  becomes  acid 
and  is  usually  so  when  used  in  the  home.  These  chemical  dif- 
ferences are  inherent  and  unavoidable.  As  milk  ages,  further 
changes  take  place  as  the  result  of  bacterial  action,  which  are 
more  or  less  deleterious  to  the  infant.  The .  conditions  under 
which  milk  is  transported  and  stored,  and  the  time  elapsing 
between  milking  and  consuming,  are  directly  concerned  in  these 
changes. 

Faulty  methods  of  production,  distribution  and  receiving  and 
caring  for  the  milk  at  the  home  give  opportunities  for  pollution 
of  and  consequent  changes  in  the  food  value  of  milk.  But  in 
spite  of  these  drawbacks  modified  cow's  milk  is  the  almost  uni- 
versal substitute  infant  food  in  this  country,  and  is  a  generally 
adequate  and  satisfactory  substitute.  Its  value  to  us  as  a  food 
for  infants  cannot  be  overestimated.  It  is  indispensable.  As 
a  possible  negative  proof  of  the  value  of  cow's  milk  as  infant's 
food  the  following  is  of  interest:  In  a  New  England  city  of 
120,000  inhabitants  the  total  daily  consumption  is  27,000  quarts 
of  raw  milk,  or  .22  quart  per  capita,  and  5,000  cans  of  con- 
densed milk.  The  infant  mortality  rate  is  171  per  1,000.  In 
investigating  the  subject  the  local  board  of  health  states  that 
raw  milk  is  used  for  infants  in  very  much  smaller  amounts  than 
it  should  be,  condensed  milk,  beer  and  coffee  being  used  in- 
stead. Dr.  Howarth  of  Derby,  Eng.,  is  quoted  by  Newman 
as  follows:  "Children  fed  on  condensed  milk  show  a  very 
high  mortality,  viz.,  255  deaths  per  1,000  of  children  so  fed." 
Physicians  would  not  ordinarily  advise  the  use  of  beer  and 
coffee  as  a  substitute  for  mother's  milk.  It  is  conceivable  that 
the  freer  use  of  raw  milk  as  a  food  for  infants  would  result  in 
a  lowering  of  the  infant  mortality  rate  in  this  particular  city. 

The  value  of  milk  as  a  food  for  adults  is,  as  a  rule,  rather 
under  than  over  estimated.  The  digestive  apparatus  of  the 
adult  can  disregard  the  chemical  unsuitabilities  with  far  more 
impunity  than  can  the  infants'.  The  worst  feature  of  milk  as 
a  sole  food  for  healthy  adults  is  that  it  is  too  wholly  digestible; 


187 

it  does  not  contain  in  itself  enough  waste  matter.  The  intes- 
tines of  an  adult  have  been  accustomed  to  a  good  percentage 
of  bulky,  inert  matter  to  serve  as  a  vehicle  for  body  wastes  in 
their  discharge.  Milk  itself  does  not  provide  this  bulky  waste, 
and  for  this  reason  may  well  be  characterized,  as  has  been  done 
by  Rosenau,  as  "too  perfect  food  for  the  adult."  Although 
perhaps  "too  perfect"  for  the  healthy  adult,  this  stricture  can- 
not hold  in  the  case  of  the  sick  adult.  •'Here  its  easy  digesti- 
bility and  perfect  balance  as  a  food  make  it  about  as  indispen- 
sable as  it  is  in  the  case  of  the  motherless  infant.  Dr.  George 
W.  Gay,  in  his  testimony  before  the  milk  committee  of  the 
Massachusetts  Legislature  in  1910,  emphasized  very  strongly 
the  value  of  milk  to  the  sick  adult.  He  said,  "Milk  is  the 
chief  food  of  sick  folks.  We  could  not  take  care  of  sick  folks 
if  we  did  not  have  milk.  The  importance  of  milk  as  a  food 
for  sick  people  —  adult  sick  people  —  cannot  be  overstated  or 
overestimated." 

Here,  again,  the  pollution  or  contamination  of  the  milk  before 
it  is  swallowed  may  reduce  its  suitability  as  a  food  to  the  point 
of  rendering  it  absolutely  dangerous  even  to  healthy  adults; 
far  more  to  sick  ones. 

tf^And,  again,  the  statements  as  to  its  food  value  hold  good. 
Its  place  as  a  food  for  adults,  particularly  sick  adults,  cannot 
be  overestimated;    it  is  indispensable. 

As  compared  with  other  foodstuffs  its  value  is  very  high,  so 
high  that  at  present  prices  it  is  one  of  our  cheapest  of  foods. 
As  a  readily  understood  comparison  take  the  following:  An 
adult  man  would  need  from  4  to  5  quarts  of  milk  daily  to 
supply  his  food  requirements.  The  food  value  of  4  quarts  of 
milk,  if  expressed  in  common  foods,  would  provide  the  follow- 
ing amount  as  a  daily  supply:  — 

'  4  eggs. 


4  quarts  of  milk, 


f  pound  lean  beef. 
2  pounds  potatoes. 
1  pound  cabbage. 
\  pound  bread. 
^  J4  pound  butter. 


This  is  not  offered  as  a  balanced  ration,  but  as  a  showing  of 
the  actual  food  value  of  milk.  In  view  of  this  great  economic 
value  of  milk  as  a  food  the  waste  that  takes  place  in  certain 


188 

phases  of  the  milk  business  is  much  to  be  regretted.  The  de- 
mand of  the  public  for  cream,  as  such,  leaves  a  large  amount 
of  skimmed  milk  that  has  an  uncertain  market.  Skimming 
milk  removes  about  two-thirds  of  the  fats,  and  hardly  touches 
the  proteins  and  carbohydrates,  and  the  proteins  are  the 
muscle-building  part  of  the  milk.  On  the  farm  this  skimmed 
milk  is  used  in  the  family,  fed  to  swine,  calves  or  chickens,  or 
thrown  away.  When  used  for  feeding,  of  course  this  valuable 
food  is  not  wasted  in  its  entirety,  but  even  then  it  is  using 
food  of  a  very  high  nutritive  value  where  a  less  valuable  one 
might  possibly  be  substituted,  provided  a  suitable  use  could 
be  found  for  the  skimmed  milk.  Where  it  can  be  obtained  in 
large  quantities,  large  enough  to  warrant  the  investment,  it  is 
manufactured  into  casein,  when  the  milk  sugar  is  entirely  lost. 
In  the  aggregate  large  quantities  of  skimmed  milk  are  wasted 
through  the  lack  of  intelligent  demand  for  a  valuable  article. 
Determined  by  the  chemical  analysis,  with  the  retail  price  of 
whole  milk  at  9  cents  per  quart,  the  actual  value  of  skimmed 
milk  is  4.6  cents  per  quart,  and  its  retail  market  price  at  date 
is  about  2  cents  per  quart.  When  people  realize  that  for  2 
cents  they  can  get  an  article  whose  actual  value  is  4.6  cents, 
it  would  seem  that  the  demand  for  it  must  increase,  that  the 
price  will  rise  and  the  waste  be  checked. 

SUMMARY   OF   PART  V. 

A  number  of  the  human  communicable  diseases  are  trans- 
mitted through  milk.  Those  of  the  most  importance  in  Massa- 
chusetts are  tuberculosis,  diphtheria,  scarlet  fever,  septic  sore 
throat  and  typhoid  fever. 

In  tuberculosis  the  milk  may  be  infected  by  the  cow  produc- 
ing it,  or  by  the  human  beings  who  handle  it. 

In  the  other  four  diseases  mentioned,  except  possibly  in  the 
case  of  scarlet  fever,  the  infection  does  not  originate  in  the 
cow;   the  source  is  in  the  human  handlers. 

The  amount  of  communicable  disease  transmission  through 
cow's  milk  has  been  overestimated,  but  such  transmission  does 
occur  in  a  degree  of  frequency  which  demands  public  protection. 

The  infection  of  milk  with  human  disease  germs  may  occur 
at  any  time  between  its  secretion  in  the  cow  and  its  consump- 
tion. 


189 

In  addition  to  infection  with  human  disease  germs  milk  may 
be  otherwise  polluted,  or  may  decay  to  a  degree  that  renders 
it  an  unsafe  food  for  human  beings. 

To  insure  its  safety  as  a  human  food  two  procedures  of  con- 
trol are  necessary. 

First  —  By  inspection  of  cattle,  methods  of  production  and 
transportation,  secure  a  supply  that  is  pure,  clean  and  fresh. 

Second.  —  By  the  application  of  heat,  destroy  all  disease 
germs  that  may  be  in  it,  whether  they  come  from  animal  or 
human  sources. 

There  are  two  methods  of  disinfection  by  heat  in  common 
use:  (a)  complete  sterilization  by  boiling,  and  (6)  partial  ster- 
ilization, "pasteurization,"  by  heating  the  milk  to  between  140° 
and  150°  F.  for  from  twenty  to  thirty  minutes. 

Both  of  these  methods  are  effective.  The  partial  steriliza- 
tion, "pasteurization,"  seems  to  have  fewer  objectionable  fea- 
tures, and  is  already  established  in  this  country  as  an  accepted, 
successful  process. 

To  obtain  the  most  perfect  results  market  milk,  intended  for 
human  consumption  as  milk,  should  be  pasteurized  under  the 
control  of  central  authority  and  in  the  final  container. 


190 


PART  VI.     THE  GRADING    OF   MILK. 


A.    GENERAL  DISCUSSION. 

It  is  the  prevailing  opinion  of  those  who  have  made  a  study 
of  the  subject  that  milk  should  be  graded,  although  it  is  evi- 
dent that  the  ideal  system  has  not  yet  been  devised.  The 
system  should  aim,  first,  to  aid  in  the  production  and  distribu- 
tion of  milk  which  is  safe  from  a  health  point  of  view,  and 
which  is  of  varied  chemical  composition.     , 

The  present  Massachusetts  statute  contemplates  to  a  slight 
extent  the  latter  consideration  by  establishing  a  minimum  stand- 
ard of  12.15  per  cent,  for  solids  and  3.35  per  cent,  for  fat,  and 
the  constitutionality  of  this  type  of  statute  has  been  repeatedly 
upheld  by  the  Supreme  Courts  of  this  and  other  States  on  the 
ground  that  it  is  a  health  law.  The  courts  recognized  the  fact 
that  the  milk  of  many  cows  did  not  come  up  to  the  standard, 
but  were  of  the  opinion  that  the  people  should  be  protected  from 
an  impoverished  food.  As  a  rule,  where  a  minimum  standard 
is  established  the  quality  of  the  milk  adapts  itself  to  the  standard. 
Massachusetts,  however,  is  an  exception  to  this  rule.  The  fig- 
ures obtained  from  the  samples  collected  by  the  inspectors  of 
the  Massachusetts  State  Board  of  Health  show  that  the  average 
milk  sold  in  this  State  is  4.5  per  cent,  above  the  standard  for 
solids  and  14.6  per  cent,  above  the  standard  for  fat.  The  dis- 
crepancy is  due  to  the  fact  that  only  a  sample  of  skimmed 
milk  can  literally  comply  with  the  standard. 

The  following  table  shows  the  average  composition  of  milk 
not  declared  adulterated,  which  has  been  collected  and  exam- 
ined by  the  Massachusetts  State  Department  of  Health. 


Yeah. 

Number 

of 
Samples. 

Solids. 

Fat. 

Solids 
not  Fat. 

1909 

4,242 

12.78 

4.10 

8.68 

1910 

12.85 

4.02 

8 

83 

1911 

4,341 

12.83 

4.00 

8 

83 

1912 

4,516 

12.66 

3.89 

8 

77 

1913 

6,154 

12.69 

3.84 

8 

85 

1914 

5,502 

12.70 

3.82 

8 

88 

1915 

6,765 

12.68 

3.82 

8 

86 

191 

Commercial  grading  of  milk  is  to  some  extent  practiced  thus: 
Many  dealers  sell  milk  of  different  fat  content,  charging  dif- 
ferent prices,  and  others  sell  one  grade  of  milk,  charging  a 
higher  price  than  the  usual  commercial  price  by  reason  of  its 
high  fat  content.  No  attempt,  however,  seems  to  have  been 
made  at  official  supervision  of  the  sale  of  milk  upon  its  chem- 
ical composition  other  than  the  necessary  establishment  of  mini- 
mum standards. 

Attempts  have  been  made  by  different  cities  and  towns  to 
control  the  sanitary  condition  of  milk  by  fixing  by  regulation 
a  maximum  bacteria  content  above  which  the  milk  cannot  be 
sold.  This  is  true  of  many  cities  and  towns  in  Massachusetts, 
but  beyond  a  few  warning  letters  and  some  newspaper  pub- 
licity but  little  attempt  seems  to  have  been  made  to  strictly 
enforce  these  regulations.1  , 

Standards  of  this  sort  are  not  to  be  construed  as  grading, 
because  they  are  applied  to  the  milk  intended  for  use  by  the 
ultimate  consumer,  and  the  retail  or  wholesale  dealer  can  easily 
devise  means  of  controlling  the  final  product  by  proper  selec- 
tion of  milk  in  the  one  instance  and  by  pasteurization  in  the 
other.  The  contractor  will  buy  high-grade  and  low-grade  milk 
at  the  same  price,  and  by  mixing  these  various  grades  of  milk 
the  fat  and  solid  content  of  the  mixture  will  more  or  less  con- 
form to  the  standard.  The  producer  under  these  circumstances 
is  paid  by  the  quart,  irrespective  of  the  fat  content  of  the  milk, 
or,  if  any  change  in  price  is  made,  it  is  liable  to  be  a  reduction 
in  the  case  of  the  low-grade  milk.  The  contractor  will  also 
buy  indiscriminately  clean  and  dirty  milk,  and  will  mix,  clarify 
and  pasteurize  it,  thus  giving  no  incentive  to  the  farmer  to 
produce  clean  milk. 

There  seems  to  have  been  no  attempt  made  on  the  part  of 
any  State  to  establish  and  control  the  grading  of  milk,  but  the 
cities  in  New  York  State,  under  the  provisions  of  the  sanitary 
code  of  the  New  York  State  Department  of  Health,  are  at- 
tempting to  do  so.  New  York  City,  however,  under  the  author- 
ity of  the  City  Health  Department,  is  maintaining  successfully 
a  grading  system,  based  upon  the  bacterial  content,  whereby 
both  the  producer  and  the  consumer  are  adequately  compen- 
sated and  protected.     This  system,  which  can  be  easily  con- 

1  Brockton  is  a  notable  exception  to  this  statement. 


192 

trolled  when  dealing  with  a  congested  population,  prohibits  the 
sale  of  raw  milk  unless  of  a  quality  resembling  certified  milk. 
This  milk  must  be  below  a  maximum  bacterial  content,  must 
be  obtained  from  tuberculin-tested  cattle  which  are  housed  in 
stables  of  a  minimum  score  on  the  special  score  card  designed 
by  the  Department.  All  other  milk  must  be  pasteurized  in 
apparatus  approved  by  the  Health  Department,  and  in  making 
the  pasteurization  regulations  the  commission  has  devised  the 
scheme  which  makes  the  system  a  success,  —  by  appealing  to 
the  commercial  instinct  of  the  dealers.  If  the  bacterial  content 
of  the  raw  milk  is  above  a  certain  fixed  maximum  this  milk 
cannot  be  pasteurized  and  sold  unless  labeled  "Grade  C,  for 
Cooking  Purposes  Only."  In  order  to  avoid  the  degrading  of 
his  product  the  contractor  must  select  his  dairies  carefully,  must 
pick  out  dairymen  who  furnish  clean  milk  of  a  low  bacterial 
content,  and,  in  order  to  obtain  sufficient  milk  to  satisfy  the 
demands  of  the  retail  trade,  must  pay  more  money  to  the 
dairymen  furnishing  such  milk.  Another  important  feature  of 
this  system  is  the  regulation  regarding  two  grades  of  pasteur- 
ized milk.  The  Grade  A  pasteurized  milk  is  obtained  from 
better  stables  and  has  a  lower  bacterial  content  before  pasteur- 
izing than  the  Grade  B  milk,  and  the  public  is  willing  to  pay 
a  higher  price  for  the  Grade  A  pasteurized  milk.  The  sales 
of  this  grade  are  said  to  be  increasing,  and  in.  order  to  comply 
with  the  demand  the  dealers  made  it  a  financial  object  for 
dairymen  to  produce  milk  of  the  Grade  A  quality  of  pasteuri- 
zation. 

The  commercial  pasteurization  of  milk  should  be  inspected 
and  carefully  controlled  by  the  health  departments.  Notwith- 
standing the  fact  that  modern  methods  of  pasteurization  render 
milk  safe,  yet  it  is  a  fact  that  pasteurized  milk  is  very  easily 
contaminated,  and  after  such  contamination  the  growth  of  the 
bacteria  is  more  rapid  than  in  the  case  of  raw  milk  less  than 
twenty-four  hours  old.  The  reinfection  of  pasteurized  milk  can 
take  place  by  means  of  a  dirty  cooling  apparatus,  dirty  air  in 
the  cooling  and  bottling  rooms,  dirty  bottles  and  dirty  help. 
A  man  sick  with  typhoid  fever  working  in  a  milk-bottling  room 
can  cause  as  much  if  not  more  damage  than  if  he  were  on  a 
farm  engaged  in  milking  cows.    An  occasional  visit  on  the  part 


193 

of  the  health  authorities,  with  a  thorough  bacteriological  exam- 
ination of  the  milk  in  all  stages  of  the  process,  will  tend  towards 
a  safer  milk  supply  than  uncontrolled  commercial  pasteuriza- 
tion. 

The  pasteurization  of  milk  should  be  permitted  but  once,  in 
order  to  render  the  process  entirely  a  health  measure  instead 
of  being  largely  a  commercial  measure.  This  will  insure  the 
sale  of  milk  of  near-by  production  and  milk  not  too  old  for 
consumption.  The  application  of  pasteurization  was  primarily 
designed  in  the  case  of  milk  for  commercial  purposes  in  order 
to  enable  dealers  to  market  milk  which,  owing  to  age,  could 
not  otherwise  be  done.  It  should  now  be  regarded  as  a  neces- 
sary health  measure,  and  its  application  be  carefully  studied 
from  this  standpoint  rather  than  from  a  standpoint  of  pure 
commercialism. 

Wherever  milk  is  bought  upon  a  fair  equitable  price  based 
upon  the  fat  content  the  producers  invariably  breed  cattle 
giving  milk  with  a  high  fat  content,  probably  due  to  the  fact 
that  they  receive  more  money  per  cow  than  if  the  milk  is 
bought  upon  a  flat  rate  per  pound  or  per  quart.  It  seems  fea- 
sible that  this  system  should  be  extended  to  selling  at  retail, 
and  it  would  result  in  the  paying  of  a  higher  price  on  the  part 
of  the  consumer  for  high-grade  milk,  and,  on  the  other  hand, 
would  encourage  the  sale  of  milk  of  a  low  fat  content  to  those 
who  could  riot  afford  to  pay  the  higher  price  of  milk  high  in 
fat.  Under  these  conditions  there  would  be  a  greater  consump- 
tion and  less  waste  than  at  present  of  that  valuable  food,  — 
skimmed  milk.  Grading  of  this  sort  could  be  carried  out  only 
after  repealing  the  skimmed  milk  law  and  permitting  the  sale 
of  mixtures  of  skimmed  milk  and  cream  in  all  proportions,  pro- 
vided that  the  customer  is  aware  of  the  fact  and  the  per  cent, 
of  fat  is  stated  upon  each  container.  This  is  to  some  extent 
illegally  practiced  by  many  dealers  who  mix  skimmed  milk 
with  high-grade  whole  milk  for  the  purpose  of  producing  a 
product  but  slightly  above  the  standard,  which  form  of  adul- 
teration if  skillfully  done  may  escape  detection  upon  chemical 
analysis.  This  process,  while  reprehensible  when  applied  to 
milk  bought  and  sold  by  volume,  is  unobjectionable  if  the 
purchase  and  sale  were  based  entirely  upon  the  fat  content. 


194 

If  a  grading  system  of  this  sort  were  instituted,  the  present 
standards  of  solids  and  fat  should  not  apply  to  milk  if  the 
containers  were  labeled  with  the  fat  content,  if  (1)  the  milk 
were  free  from  added  water,  and  (2)  if  it  complied  with  a  mini- 
mum solids  not  fat  standard  based  on  a  sliding  scale  of  8.7  per 
cent,  in  skimmed  milk  or  milk  with  0  per  cent,  fat,  and  of  0.0 
per  cent,  in  a  hypothetical  milk  with  100  per  cent.  fat. 


195 


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197 


Table  II.  —  Comparison  of  Prices  and  Values  of  Milk,  Skimmed  Milk 

and  Cream  by  Various  Methods  of  Computation. 

Skimmed  Milk. 


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1.6 

2.2 

1.7 

2.5 

2.9 

3.6 

3.8 

5.9 

4.1 

7.6 

2 

229 

2.2 

2.5 

2.5 

2.9 

3.8 

4.1 

5.6 

6.7 

5.7 

8.6 

3 

262 

2.9 

2.8 

3.2 

3.3 

4.7 

4.6 

7.4 

7.6 

7.3 

9.8 

Whole  Milk. 


4 

316 

3.53 

3.5 

4.0 

4.0 

5.6 

5.6 

9.2' 

9.2 

8.9 

11.8 

5 

369 

4.1 

4.1 

4.7 

4.7 

6.5 

6.5 

11.0 

10.7 

10.5 

13.7 

6 

421 

4.7 

4.7 

5.4 

5.3 

7.4 

7.5 

12.8 

12.3 

12.1 

15.7 

7 

470 

5.3 

5.2 

6.2 

6.0 

8.3 

8.3 

14.6 

13.7 

13.7 

17.5 

Cream. 


8 

488 

6.0 

5.4 

6.9 

6.2 

9.2 

8.7 

16.4 

14.2 

15.3 

18.5 

9 

526 

6.6 

5.8 

7.7 

6.8 

10.1 

9.3 

18.2 

15.3 

16.9 

19.6 

10 

567 

7.2 

6.3 

8.4 

7.2 

11.0 

10.0 

20.0 

16.5 

18.5 

21.1 

15 

769 

10.3 

8.5 

12.0 

9.7 

15.5 

13.4 

29.0 

22.4 

26.5 

28.7 

20 

972 

13.4 

10.8 

15.8 

12.3 

20.0 

17.2 

38.0 

28.2 

34.5 

36.2 

25 

1,176 

16.5 

13.0 

19.5 

14.8 

24.5 

20.8 

47.0 

33.2 

42.5 

44.0 

30 

1,378 

19.6 

15.2 

23.2 

17.5 

29.0 

24.4 

56.0 

40.0 

50.5 

51.6 

35 

1,579 

22.7 

17.4 

26.9 

19.9 

33.5 

28.0 

65.0 

45.8 

58.5 

59.1 

40 

1,783 

25.8 

19.7 

30.5 

22.5 

38.0 

31.5 

74.0 

51.7 

66. 55 

66.5 

45 

1,985 

28.9 

21.9 

34.3 

25.0 

42.5 

35.0 

83.0 

57.7 

74.5 

74.0 

50 

2,188 

32.0 

24.3 

38.0 

27.6 

47.0 

38.7 

92.0 

63.7 

82.5 

81.0 

55 

2,390 

35.1 

26.5 

41.7 

30.3 

51.5 

42.4 

101.0 

69.6 

90.5 

89.2 

60 

2,593 

38.2 

28.7 

45.4 

32.8 

56.0 

45.9 

110.0 

75.4 

98.5 

96.6 

1  Purchasing  prices  of  Turner  Centre  Dairying  Association. 

*  Selling  prices  of  Turner  Centre  Dairying  Association. 

»  Boston  contractors  pay  from  3  to  3.5  cents  per  quart  for  milk. 
«  Retail  price  of  milk,  9  cents  per  quart  at  3.7  per  cent.  fat. 

*  Retail  price  of  cream,  60  cents  per  quart,  at  30  to  40  per  cent.  fat. 


198 

Under  such  a  grading  system  the  price  could  be  established 
in  a  manner  similar  to  that  now  employed  by  the  Turner 
Centre  Dairying  Association,  —  by  paying  a  flat  price  per  quart 
plus  the  value  of  the  butter  fat  at  an  established  price  per 
pound.1  The  tables  on  pages  195  and  197  show  the  composition 
of  skimmed  milk,  milk  and  cream,  its  food  values  in  calories 
per  pound,  its  cost  and  selling  price  calculated  as  described 
above,  and  its  monetary  value  at  a  definite  price  per  calorie. 
The  data  from  which  the  composition  of  the  milk  has  been 
computed  can  be  found  in  the  reports  of  the  analyst  of  the 
Massachusetts  State  Board  of  Health,  1907-14.  Judging  from 
these  computations  and  the  data  obtained  from  milk  producers, 
the  Boston  milk  contractors  are  buying  butter  fat  from  the 
farmer  at  about  31  cents  per  pound,  and  selling  it  at  about 
85  cents  per  pound  to  their  retail  trade. 

A  study  of  Table  II.  will  show  that  the  prices  paid  for 
cream  are  much  higher  than  the  increased  food  value  should 
warrant,  and  that  the  skimmed  milk  is  far  more  valuable  than 
its  market  price.  At  the  present  price  of  skimmed  milk  (2 
cents  per  quart)  cream  containing  40  per  cent,  fat  is  worth 
22.6  cents  per  quart,  and  at  the  present  price  of  cream  (60 
cents  per  quart)  skimmed  milk  is  worth  5.9  cents  per  quart. 
It  is  indeed  unfortunate  in  these  days  of  high  food  prices  that 
such  a  quantity  of  valuable  and  highly  digestible  protein  and 
carbohydrate  food  is  wasted,  owing  to  the  excessive  demand 
on  the  part  of  the  public  for  cream. 

The  grading  of  milk  by  the  New  York  City  Health  Depart- 
ment has  been  successfully  carried  out  by  limiting  the  number 
of  bacteria  before  and  after  pasteurization,  and  the  dealers  now 
comply  with  the  regulations  without  any  serious  objections; 
but  on  the  contrary,  no  attempt  has  been  made  to  establish 
by  law  or  regulation  the  sale  of  milk  upon  its  merits  according 
to ,  its  chemical  composition  or  food  value.  Any  attempt  to 
establish  the  latter  form  of  grading  would  be  in  the  nature  of  an 
experiment,  but  would  in  all  probability  be  easier  of  operation 
and  control  than  the  bacteriological  grading  system,  because 

1  The  Turner  Centre  Dairying  Association  in  October,  1916,  was  buying  milk  or  cream  at  50 
cents  per  100  pounds  plus  37  cents  per  pound  of  butter  fat,  and  was  selling  milk  or  cream  at  $1 
per  100  pounds  plus  45  cents  per  pound  of  butter  fat.  The  sale  of  this  milk  or  cream  is  almost 
entirely  wholesale  by  this  company. 


199 

the  wholesale  business  in  milk  is  now  carried  on  in  many  places 
by  payment  upon  the  fat  basis.  The  public  could  estimate  to 
some  extent  the  difference  between  different  grades  by  the 
cream  line,  and  furthermore,  the  fat  content  is  more  easily 
and  accurately  determined  than  the  bacteria  content,  and  is 
not  so  liable  to  fluctuation. 

A  requirement  that  all  milk  should  be  pasteurized  could  be 
easily  carried  on  without  hardship  in  but  few  cities  and  towns 
in  Massachusetts,  notably  Boston,  Cambridge,  Somerville, 
Everett,  Chelsea,  Revere  and  Winthrop.  Outside  of  these 
localities,  with  but  few  exceptions,  the  bulk  of  the  milk  sold 
is  raw  milk,  and  is  sold  by  small  dealers,  many  of  whom  own 
their  own  cows  and  market  their  own  and  their  neighbors' 
milk.  Many  contractors  in  smaller  cities  do  not  resort  to  pas- 
teurization, since  their,  milk  comes  from  near-by  cities  and 
towns,  and  pasteurization  is  therefore  not  a  commercial  neces- 
sity, and  for  them  it  would  in  many  instances  be  an  expendi- 
ture unwarranted  from  a  commercial  standpoint  by  the  size  of 
their  business,  although  public  health  might  warrant  its  appli- 
cation. The  most  efficient  pasteurization  from  the  commercial 
standpoint  is  the  continuous  process  in  which,  by  the  holding 
system,  it  is  necessary  to  have  sufficient  milk  to  take  at  least 
thirty  minutes  in  flowing  past  a  given  point  in  the  apparatus. 
The  flash  process  can  be  operated  with  a  smaller  quantity  of 
milk,  as  it  requires  but  fifteen  to  forty-five  seconds  for  the 
milk  to  pass  from  the  mixing  tank  through  the  heater,  over 
the  cooler  to  the  bottles.  This  process,  while  more  expensive 
to  operate  because  of  the  higher  temperature  to  be  attained, 
however,  is  open  to  the  objections  that  the  tubercle  bacillus 
may  not  be  killed  in  the  short  time  it  is  exposed  to  the  heat. 
It  is,  however,  very  efficient  in  reducing  the  number  of  bac- 
teria, and  causes  no  coagulation  of  the  milk  albumin. 

The  prohibition  of  the  sale  of  raw  milk  from  other  than 
tuberculin-tested  cattle  could  not  be  put  into  immediate  opera- 
tion in  Massachusetts  without  causing  a  milk  famine  for  a 
time  at  least,  as  undoubtedly  90  per  cent,  of  the  Massachu- 
setts dairies  supply  milk  from  cows  not  so  tested.  The  dairy 
scores  of  the  Massachusetts  State  Department  of  Health  ob- 
tained during  1913,  1914  and  1915  substantiate  this  statement 


200 

as  do  the  data  furnished  by  the  State  Department  of  Animal 
Industry;  in  fact,  the  figures  furnished  for  1915  indicate  a 
much  smaller  percentage  of  tuberculin-tested  cattle  in  Massa- 
chusetts than  during  1914. 

A  requirement  that  all  raw  milk  sold  in  Massachusetts  should 
come  from  dairies  with  a  relatively  high  score  on  the  United 
States  score  card  would  put  50  to  60  per  cent,  of  the  milk  pro- 
ducers out  of  business,  and  would  cause  a  milk  famine  in  all 
places  other  than  large  cities  and  towns  where  the  sale  of  pas- 
teurized milk  is  the  rule,  and  would  play  directly  into  the  hands 
of  the  large  dealers.  It  is  possible,  however,  to  devise  a  modi- 
fied score  card  where  great  stress  is  laid  upon  methods  and  less 
upon  equipment  than  in  the  present  score  card. 

If  grading  were  entirely  a  matter  of  local  option  its  adoption 
and  operation  would  probably  be  carried  on  as  extensively  in 
the  future  as  at  present,  since  each  city  and  town  can  now 
adopt  such  a  system  under  chapter  744  of  the  Acts  of  1914, 
and  none  have  seen  fit  to  do  so.  The  local  adoption  of  such 
a  system  in  Massachusetts  would  lead  to  serious  disturbances 
among  dealers  who  sell  the  same  product  in  several  towns,  and 
it  would  result  in  selling  elsewhere  the  milk  too  poor  to  conform 
to  the  requirements  of  certain  localities.  The  cost  of  operating 
the  system  would  be  so  high  that  many  cities  and  towns  would 
be  unable  to  enjoy  its  benefits.  Such  a  system  should  be  en- 
acted by  statute,  and  should  be  enforced  by  a  central  authority, 
—  the  State  Health  Department,  —  since  the  system  has  as 
its  prime  motive  the  health  of  the  people. 

B.    RELATION  BETWEEN  SOLIDS  AND  FATS  IN    MILK. 

The  chemical  analyses  of  milk  made  by  the  analysts  of  the 
Massachusetts  State  Department  of  Health  have  shown  that 
a  fairly  definite  relation  exists  between  the  percentage  of  solids 
and  of  fat.  If  in  the  average  sample  the  per  cent,  of  fat  is 
much  higher  than  the  normal  fat  corresponding  to  the  solids  the 
sample  is  probably  watered,  and  if  much  lower,  the  sample  is 
probably  skimmed.  The  greater  the  difference  between  the 
normal  fat  and  the  fat  determined  upon  analysis  the  greater 
the   probability   of   adulteration.      The   State   Department   of 


201 

Health  has  collected  and  examined  during  the  past  nine  years 
1,000  samples  of  milk  of  known  purity  from  individual  cows; 
that  is,  these  cows  were  milked  in  the  presence  of  an  analyst 
or  inspector  of  the  State  Department  of  Health,  the  milk  of 
each  cow  was  thoroughly  mixed,  and  a  sample  was  taken  and 
examined  in  the  laboratory.  These  analyses  were  made  for 
the  purpose  of  ascertaining  the  minimum  percentage  of  ingre- 
dients below  which  milk  could  be  declared  adulterated;  there- 
fore the  majority  of  the  samples  were  taken  from  cows  giving 
a  heavy  flow  of  milk  and  from  those  breeds  known  to  give 
relatively  poor  milk.  The  relation  between  the  solid  and  the 
fat  content  of  the  samples  has  been  determined  for  each  0.1 
variation  of  solids  between  10  and  16  per  cent.,  and  for  each 
0.1  variation  of  the  fat  between  2.4  and  6.4  per  cent.,  from 
which  relation  the  average  solids  and  fat  for  each  0.1  variation 
of  either  ingredient  has  been  calculated.  This  table  is  too 
bulky  for  insertion,  and  a  summary  has  been  made  and  is 
presented  herewith. 

During  the  year  1913  the  Department  collected  and  exam- 
ined 6,044  samples  of  commercial  milk  which  could  not  be 
declared  adulterated  by  the  methods  of  analysis  employed.  The 
relation  between  the  solids  and  fat  content  of  these  samples 
was  determined  in  a  similar  manner  to  that  employed  with 
the  known  purity  samples.  The  summary  of  this  table  is 
presented  herewith; 


202 


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203 


After  the  averages  had  been  computed  it  was  found  that  the 
known  purity  samples  up  to  14.7  per  cent,  solids  were  rela- 
tively higher  in  fat  than  the  commercial  samples,  but  above 
this  percentage  of  solids  were  relatively  lower.     The  detection 

FAT  -  RER  CENT 


of  skimming  is  difficult  when  the  fat  content  is  between  3  and 
5  per  cent.,  and  the  differentiation  between  milk  and  cream 
is  difficult  when  the  fat  content  is  between  5  and  7  per  cent. 
These  two  conditions  probably  account  to  some  extent  for  the 
difference  between  the  two  sets  of  averages.  The  curve  of  the 
average  solids  and  fat  is  shown  in  the  above  chart. 


204 


At  the  request  of  Prof.  George  C.  Whipple  these  analyses 
were  plotted  upon  the  arithmetic  probability  scale  of  Hazen 
and  Whipple.    The  percentages  are  so  arranged  upon  this  scale 


PSRCEMT  OJ* /NGffEDtENrS 


that  if  the  data  are  obtained  in  sufficient  quantity,  and  the 
variable  follows  the  law  of  probability,  the  resulting  curve  will 
be  a  straight  line.  While  the  lines  obtained  in  these  instances 
are  not  straight,  they  are  so  nearly  straight  that  we  are  jus- 


205 

tified  in  assuming  that  sufficient  samples  have  been  examined 
from  which  definite  conclusions  can  be  drawn. 

In  the  probability  chart  presented  herewith  the  abscissae 
(horizontal  dimensions)  represent  the  per  cent,  of  samples,  and 
the  ordinates  (vertical  dimensions)  represent  the  maximum  per- 
centage of  ingredients.  For  example,  20  per  cent,  of  the  known 
purity  samples  contained  less  than  11.6  per  cent,  solids,  3.3 
per  cent,  fat  and  8.2  per  cent,  solids  not  fat.  Twenty  per  cent, 
of  the  commercial  samples  contained  less  than  11.9  per  cent, 
solids,  3.1  per  cent,  fat  and  8.29  per  cent,  solids  not  fat.  Not- 
withstanding the  fact  that  the  solids  were  higher  by  0.3  in  the 
commercial  samples,  the  fat  was  lower  by  0.2,  a  difference  of 
about  7  per  cent,  in  the  total  fat  content.  Forty  per  cent,  of 
the  samples  in  each  instance  contained  less  than  12.35  per  cent, 
solids,  the  known  purity  samples  containing  less  than  3.7  per 
cent,  fat,  and  the  commercial  samples  containing  less  than  3.3 
per  cent,  fat,  a  difference  of  0.4,  or  about  11  per  cent.,  of  the 
total  fat  content. 

Under  the  assumption  that  the  average  commercial  samples 
should  contain  the  same  average  fat  as  the  known  purity 
samples  of  the  same  total  solids  content,  the  per  cent,  of  fat 
corresponding  to  the  per  cent,  of  solids  has  been  calculated  and 
inserted  in  the  chart  as  a  dot  and  dash  line,  and  the  space  be- 
tween the  calculated  and  found  fat  percentages  has  been  cross- 
hatched  in  order  to  emphasize  the  deficiency  in  fat  of  the  com- 
mercial samples.  When  the  fat  exceeds  5.2  per  cent.,  however, 
the  commercial  samples  have  a  higher  fat  content  than  those 
of  known  purity,  probably  because  samples  of  low-grade  cream, 
claimed  by  the  dealer  to  be  milk  when  the  inspector  took  the 
samples,  are  included  in  this  portion  of  the  chart.  These  sam- 
ples, however,  are  less  than  1  per  cent,  of  the  total  number. 

Ninety-nine  per  cent,  of  the  average  samples  had  less  fat  than 
would  be  expected  if  they  are  judged  by  the  average  quality 
of  the  1,000  samples  of  known  purity. 


206 


PART    VII.     EXPERIENCES    OF    OTHER   LOCALITIES. 


A.  REPORT  ON  AN  INVESTIGATION  OF  THE  NEW  YORK 
CITY  MILK  GRADING  SYSTEM  IN  THE  CITY  OF  NEW 
YORK. 

On  October  4  representatives  of  the  State  Department  of 
Health  visited  the  Department  of  Health  of  the  city  of  New- 
York,  and  saw  Mr.  Lucius  P.  Brown,  chief  of  the  Division  of 
Foods,  and  Mr.  Russel  Sturgis,  director  of  the  Milk  Inspection 
Department. 

The  present  system  of  milk  grading  in  New  York  City  has 
been  in  operation  for  nearly  three  years,  and  is  meeting  with  great 
success  and  producing  good  results.     There  are  four  grades :  — 

Grade  A,  {        '.      .     , 
{  pasteurized. 

Grade  B,      pasteurized. 

Grade  C,      pasteurized. 

All  these  grades  must  be  properly  labeled,  and  Grade  C  must 
be  labeled  "For  Cooking  Purposes  Only."  Milk  can  be  pas- 
teurized only  once.  The  Grade  A  raw  milk ,  is  substantially 
the  same  as  certified  milk.  The  Grade  A  pasteurized  milk  is 
of  the  same  quality  as  Grade  A  raw  milk,  except  the  cows  need 
not  be  tuberculin  tested.  The  Grade  B  raw  has  been  discon- 
tinued. The  following  table  shows  the  grading  system  practiced 
in  New  York  City:  — 

Grade  A. 

1.  Raw. 

Dairies :  — 

Equipment, 25 

Methods,         ..."..* 50 

Bacteria:  — ■ 

60,000  per  cubic  centimeter. 

2.  Pasteurized. 

Dairies:  — 

Equipment, 25 

Methods, 43 

Bacteria :  — 

200,000  per  cubic  centimeter  before  pasteurizing. 

30,000  per  cubic  centimeter  after  pasteurizing. 


207 


Grade  B. 
Pasteurized. 
Dairies : 1  — 

Equipment, 20 

Methods, 35 

Bacteria :  — 

1,500,000  per  cubic  centimeter  before  pasteurizing  in  city. 
300,000  per  cubic  centimeter  before  pasteurizing  in  country. 
100,000  per  cubic  centimeter  after  pasteurizing. 

Grade  C. 
Pasteurized. 
Dairies:  — 

Total, 40 

Bacteria :  — 
300,000  per  cubic  centimeter. 

If  milk  does  not  comply  with  the  requirements  of  the  rules 
and  regulations  it  may  be  degraded.  One  of  the  principal  fea- 
tures of  this  system  is  the  requirement  that  milk  containing 
more  than  a  maximum  of  bacteria  shall  not  be  pasteurized. 
This  makes  it  incumbent  upon  the  milk  dealer  to  see  that  the 
farmer  is  careful  in  milking,  and  that  he  cools  the  milk  and 
delivers  it  as  soon  after  milking  as  possible.  A  vast  majority 
of  the  Grade  B  sold  in  New  York  City  reaches  the  consumer 
not  more  than  thirty-six  hours  old. 

For  the  control  of  pasteurizing  plants  18  country  inspectors 
are  employed  and  three  city  inspectors.  These  numbers  vary 
from  time  to  time.  Each  pasteurizing  plant  is  supposed  to  be 
covered  once  per  month,  the  inspector  taking  from  16  to  30 
samples  in  each  plant.  He  carries  a  special  ice  box  in  which  are 
placed  1-ounce  vials  with  a  screw-capped  metal  cover,  and  carries 
a  bundle  of  sterilized  aluminum  pipettes  about  2  feet  long. 

In  the  ordinary  inspection  of  a  pasteurizing  plant  the  in- 
spector takes  4  samples  from  the  mixing  vat,  4  from  the  out- 
let of  the  holding  tank,  4  from  the  outlet  of  the  cooler,  4  from 
the  bottles  ready  for  shipment.  The  time  the  samples  are 
taken  is  noted  upon  the  sheet,  and  also  the  temperature  of 
the  milk  and  the  bottle  number.  Under  extraordinary  con- 
ditions samples  are  also  taken  from  the  outlet  of  the  clarifier, 
from  the  outlet  of  the  heater,  and,  if  more  than  one  holding 

1  At  present  not  enforced. 


208 

tank  is  employed,  from  each  of  the  several  tanks.  The  in- 
spector, furthermore,  makes  a  record  upon  a  separate  sheet  of 
the  name  of  the  pasteurizing  plant,  the  character  of  the  pas- 
teurizing apparatus,  the  temperature  to  which  the  milk  was 
heated,  the  length  of  time  it  was  held,  the  temperature  of  hold- 
ing, the  temperature  at  which  it  was  received,  and  the  tem- 
perature to  which  it  was  cooled.  The  bottles  and  cards  con- 
taining the  original  data  of  collection  are  then  transported 
either  in  person  by  the  city  inspectors,  or  by  express  by  the 
country  inspectors,  to  the  bacteriological  laboratory.  From  the 
samples  taken  from  the  mixing  vat  two  dilutions  are  made  — 
1-100  and  1-10,000  —  and  a  composite  sample  is  taken  for  the 
isolation  of  the  colon  bacillus.  The  samples  of  heated  milk 
are  plated  from  dilutions  of  from  1-100,  and  the  colon  bacillus 
is  isolated  from  the  sample  from  the  holder.  In  addition  to 
this  a  sample  of  the  water  is  sometimes  taken,  and  a  sample 
of  can  rinsings  and  bottle  rinsings.  For  this  latter  purpose 
the  inspector  carries  a  bottle  containing  50  cubic  centimeters  of 
sterile  water.  The  contents  of  these  bottles  are  poured  into  a 
bottle  or  can  which  is  thoroughly  shaken  and  the  liquid  returned 
to  the  original  bottle.  These  samples  are  plated  straight  and 
1-100  dilution.  The  results  of  the  4  samples  are  averaged,  and 
the  average  figure  taken  upon  which  to  base  the  opinion  of 
the  conditions  at  the  plant. 

The  Department  permitted  access  to  the  records,  and  the 
results  of  50  inspections  were  copied,  omitting,  however,  the 
name  of  the  dealer.  The  following  are  characteristic  results 
from  pasteurizing  plants  operated  under  good  conditions  and 
under  poor  conditions :  — 

Plant  operated  under  Good  Conditions. 


Character  of  Milk. 


Bacteria 
per  Cubic  Centi- 
meter. 


Raw 

At  various  stages  of  pasteurization:  — • 
From  outlet  of  holding  tank, 
From  outlet  of  cooler,     . 
From  cans 


124,5001 

2,7002 

275 

1,975 


1  Colon  bacillus  present  in  dilution  of  1-100. 

2  Colon  bacillus  not  present  in  4  cubic  centimeters. 


209 
Plant  operated  under  Poor  Conditions. 


Chabacter  of  Milk. 


Bacteria 
per  Cubic  Centi- 
meter. 


Raw, 

At  various  stages  of  pasteurization:  — 
From  outlet  of  pasteurizer,    . 
From  outlet  of  holding  tank, 
From  outlet  of  cooler,     . 
From  cans, 


18,850,000! 

15,000,000 

100 

15,000 

60,000 « 


1  Colon  bacillus  present  in  dilution  of  1-10,000. 

The  dealer  was  notified  to  label  this  product  Grade  C. 

The  bacteriological  laboratory  makes  300  bacteria  counts  per 
day.  The  work  is  done  by  8  women  who  are  paid  about  $40 
per  month  each.  They  work  under  the  direction  of  a  woman 
who  is  a  competent  bacteriologist  and  doctor  of  medicine.  She 
has  nothing  whatever  to  do  with  the  reporting  of  the  results  to  the 
milk  dealers,  and  gives  out  no  information  regarding  the  work. 
The  women  who  do  the  actual  work  are  divided  into  two 
groups.  They  plate  samples  upon  one  day  and  count  upon 
the  next  day,  and  the  work  is  so  arranged  that  if  one  of  them 
is  sick  another  can  take  her  place.  A  large  clerical  force  is 
used  to  compile  the  results.  Dealers  are  not  prosecuted,  and 
in  general  a  threat  to  degrade  the  milk  is  sufficient  to  induce 
the  dealer  to  locate  the  trouble  and  make  the  necessary  cor- 
rections. 

On  October  5  a  commercial  laboratory  in  New  York  City 
was  visited,  and  the  secretary  and  the  director  were  interviewed. 
Inquiries  were  made  regarding  the  practical  application  of  the 
New  York  grading  system.  Both  men  were  of  the  opinion  that 
the  system  is  all  right,  provided  the  regulations  are  reasonable. 
They  criticized  the  recent  regulations  requiring  milk  dealers  to 
sell  milk  containing  not  less  than  8.5  per  cent,  solids  not  fat. 
They  stated  that  grading  had  come  to  stay,  but  the  ideal  sys- 
tem had  not  yet  been  devised.  The  present  conditions  are 
infinitely  better  than  former  conditions,  and  no  person  would 
care  to  go  back  to  the  old  system.  This  laboratory  does  a 
large   amount  of   work  for   commercial   milk   dealers,   and   its 


210 

opinions  would  naturally  be  somewhat  antagonistic  to  the 
Department  of  Health  of  New  York  City. 

A  milk  contracting  company  was  visited,  and  the  chief  veter- 
inarian and  a  member  of  the  sales  department  were  interviewed. 
The  veterinarian  stated  that  the  company  maintained  11  veter- 
inary inspectors  and  a  local  inspector  at  each  country  pasteur- 
izing plant.  The  veterinarians  make  systematic  visits  t©  the 
dairies,  each  dairy  being  visited  on  an  average  of  every  six  to 
eleven  months.  The  local  inspectors  situated  at  the  pasteuriz- 
ing plants  are  expected  to  visit  each  dairy  at  least  every  month. 
These  visits  are  made  for  the  purpose  of  seeing  that  the  cattle 
are  healthy,  as  tuberculin  testing  is  required  for  the  sale  of 
Grade  A  raw  milk,  but  on  the  average  more  for  the  purpose 
of  seeing  that  the  dairies  are  kept  in  such  condition  that  the 
raw  milk  will  fall  below  the  maximum  bacteria  requirement, 
above  which  it  cannot  be  pasteurized  without  being  degraded. 

The  company  purchase  milk  upon  the  fat  basis,  but  they 
sell  their  milk  by  the  quart.  On  inquiring  the  reason  for  this 
difference  the  representative  of  the  company  stated  it  was  nec- 
essary to  do  so  in  order  to  obtain  milk  of  sufficiently  high  fat 
content  so  that  it  could  be  sold  in  New  York  without  violating 
the  requirements  of  the  Department  of  Health.  It  also  en- 
couraged the  production  of  high-grade  milk  and  discouraged 
the  production  of  butter  on  the  farm.  Shortly  after  they  began 
to  pay  for  milk  upon  the  percentage  of  butter  fat  it  contained, 
one  farmer  stated  that  he  purchased  butter  for  the  first  time 
in  eleven  years.  The  result  of  this  method  of  buying  has  in- 
creased the  quality  of  milk  which  the  company  have  obtained 
from  the  farmers,  because  they  are  getting  all  the  cream  given 
by  the  cows.  The  milk  is  sold  by  the  quart,  the  prices  vary- 
ing according  to  the  bacteriological  grades  of  the  New  York 
City  Department  of  Health. 

When  asked  whether  or  not  the  people  of  the  city  of  New 
York  appreciated  the  grading  system, 'it  was  stated  that  the 
increase  in  the  sale  of  Grade  A  pasteurized  milk  had  been  so 
rapid  that  they  could  not  obtain  caps  for  the  bottles  fast 
enough  from  the  manufacturers. 

In  answer  to  an  inquiry  as  to  whether  or  not  they  had  any 
trouble  with  the  city  Department  of  Health  regarding  the  oper- 


211 

ation  of  the  rules  and  regulations,  it  was  stated  that  the  com- 
pany had  no  trouble  with  the  Department  of  Health  in  any  of 
their  country  pasteurizing  plants. 

The  company  stated  that  they  began  inspection  work  before 
the  New  York  City  Department  of  Health  started  the  grading 
system.  They  are  of  the  opinion  that  the  dealer  should  be 
regarded  as  a  factor  in  milk  production,  and  be  given  proper 
recognition;  and  the  larger  the  dealer  the  better  for  both  the 
producer  and  the  consumer.  There  is  considerable  competition 
between  dealers  in  the  producing  territory,  and  this  statement 
was  confirmed  by  others.  If  the  dairymen  are  all  producing 
milk  of  good  quality  they  will  sell  at  the  best  prices.  Naturally, 
the  largest  dealers  will  get  the  best  retail  trade,  have  less  bad 
bills,  and  can  therefore  afford  to  give  the  most  money  for  the 
raw  milk  and  pick  out  the  best  dairies.  The  chief  veterinarian 
of  the  company  was  of  the  opinion  that  the  farmers  under  the 
best  circumstances  could  not. go  into  the  retail  milk  business 
and  make  a  profit.  The  sales  manager  stated  that  he  was  of 
the  opinion  that  Massachusetts  milk  contractors  did  not  in- 
spect their  dairies,  and  he  knew  that  one  Massachusetts  com- 
pany made  no  dairy  inspection  in  the  buying  districts  where 
they  came  in  competition  with  the  New  York  company.  Tnis 
was  confirmed  by  a  statement  made  by  one  of  the  New  York 
City  inspectors,  that  the  dairies  which  were  rejected  by  the 
New  York  company  were  accepted  by  the  Massachusetts  com- 
pany. Both  representatives  of  the  New  York  company  were  of 
the  opinion  that  grading  has  come  to  stay  and  will  be  extended. 

They  were  asked  regarding  the  grading  of  milk  in  cities  in 
New  York  State  other  than  the  city  of  New  York,  and  stated 
that  the  grading  law,  with  a  very  few  exceptions,  would  not 
be  enforced  by  small  local  boards  of  health.  These  local  boards 
of  health  made  regulations  wdiich  were  not  reasonable,  by  reason 
of  the  fact  that  they  knew  nothing  about  the  business,  and 
most  boards  would  not  enforce  a  grading  law  by  reason  of  the 
fact  that  they  had  no  money  to  do  so,  or  did  not  care  to  insti- 
tute any  complaints  against  their  neighbors.  When  asked  what 
was  the  smallest  possible  quantity  of  milk  wdiich  could  be  pas- 
teurized without  pecuniary  loss  neither  man  cared  to  give  an 
opinion. 


212 

Another  company  was  next  visited,  and  the  manager  was 
interviewed.  He  stated  that  in  his  opinion  the  grading  system 
was  all  right,  but  the  regulations  should  not  be  changed  quite 
so  frequently.  New  regulations  caused  considerable  trouble  to 
the  dealer,  who  would  naturally  purchase  a  large  stock  of  caps 
for  the  milk  bottles,  and  under  changing  regulations  mxny  of 
these  caps  became  obsolete,  and  therefore  had  to  be  destroyed. 

He  believed  the  grading  system  is  a  good  thing,  and  should  be 
encouraged,  but  other  communities  should  follow  the  New  York 
City  system  as  closely  as  possible,  in  order  to  obtain  uniformity  in 
methods  of  production  and  distribution.  He  was  of  the  opinion 
that  the  public  did  not  appreciate  the  grading  system  as  it 
should,  and  bought  milk  upon  the  recommendation  of  other 
people,  or  of  their  family  physicians,  and  in  general  bought  the 
grade  most  suited  to  their  means. 

An  assistant  manager  of  this  company  stated  that  when  the 
grading  system  was  first  established  it  was  regarded  by  the 
dealers  as  an  imposition.  At  present  he  has  no  objection  to 
the  system  as  a  whole,  but  does  object  to  the  changes  in  the 
regulations,  specifically  the  recent  regulation  requiring  a  mini- 
mum solids  not  fat  of  8.5  per  cent.  He  stated  that  some  local 
regulations,  specifically  those  of  Buffalo,  were  more  rigid  than 
the  New  York  City  regulations,  but  in  general,  outside  of  the 
city  of  New  York,  little  attempt  was  made  to  grade  milk  in 
New  York  State. 

This  company  employ  11  inspectors,  3  of  which  are  veteri- 
narians. They  spend  their  entire  time  in  inspecting  dairies,  and 
each  man  inspects  about  300  per  month.  The  cost  to  the  com- 
pany is  about  $25,000  per  annum,  of  which  $15,000  is  for 
salaries.  The  reason  for  the  low  expense  account  is  due  to  the 
fact  that  the  men  live  in  their  inspecting  territory,  and  travel 
around  by  means  of  automobiles,  which  they  own,  the  main- 
tenance of  which  is  paid  by  the  company.  The  assistant  man- 
ager thinks  this  is  better  than  the  other  systems  of  -inspection, 
where  local  inspectors  are  employed  in  the  forenoon  as  can 
receivers  and  in  the  afternoon  as  inspectors.  He  believes  that 
acting  in  the  former  capacity  is  beneath  the  dignity  of  an  in- 
spector, and  the  dairymen  look  upon  it  in  this  way;  but  when 
a  man  is  inspecting  all  the  time  he  commands  the  respect  of 
the  farmers.     They  buy  milk  upon  the  bacterial  content  and 


213 

upon  the  fat  per  cent.  He  thinks  that  the  board  of  health 
should  score  the  milk,  and  not  the  dairy. 

This  company  also  purchase  small-top  milk  pails  by  carload 
lots,  and  sell  them  to  their  dairymen  at  cost  price,  which 
amounts  to  about  75  cents  per  pail.  The  inspectors,  however, 
find  that  the  farmers  are  often  very  lax  in  the  use  of  such  pails. 
A  copy  of  a  chart  was  furnished  showing  the  bacterial  content 
of  the  raw  milk  received  in  their  New  York  pasteurizing  plants 
each  month  during  the  past  three  years.  This  work  was  done 
by  a  commercial  laboratory,  about  10,000  samples  being  exam- 
ined each  year.  The  figures  for  1914  are  considerably  below 
those  obtained  in  1913,  and  the  figures  for  1915  are,  in  all 
cases,  below  the  requirements  of  the  New  York  City  Depart- 
ment of  Health  for  Grade  B  pasteurized  milk.  This  bringing 
down  of  the  bacteria  count  was  entirely  the  result  of  the  in- 
spections made  and  the  advice  given  to  the  dairymen  by  the 
company.  The  assistant  manager  would  not  state  definitely 
how  small  a  quantity  of  milk  could  be  pasteurized  at  a  profit. 
He  was  of  the  opinion,  however,  that  a  dealer  could  operate 
a  single  tank  set,  in  which  the  milk  was  heated,  held  and 
cooled,  without  removal  from  the  tank. 

On  October  6  Dr.  Hermann  Biggs,  Commissioner  of  Health 
for  the  State  of  New  York,  was  interviewed.  In  response  to 
inquiries  relative  to  the  operation  of  the  grading  system  in 
New  York  State,  Dr.  Biggs  stated  that  the  system  is  working 
as  well  as  could  be  expected,  and  a  number  of  cities  and  towns 
which  never  had  done  any  milk  work  were  now  beginning  to 
do  some  work.  The  grades  are  the  same  as  those  adopted  by 
New  York  City,  but  each  city  or  town  in  the  State  has  the 
right  to  make  rules  and  regulations  which  may  be  more,  but 
must  not  be  less,  rigid  than  those  of  the  New  York  State  De- 
partment of  Health.  Some  cities,  notably  the  city  of  Buffalo, 
have  made  regulations  more  rigid  than  the  regulations  of  the 
State.  Dr.  Biggs  was  asked  if  there  were  any  cities  in  New  York 
State  with  conditions  analogous  to  those  of  Boston,  where  one 
city  is  making  the  dairy  inspections,  and  making  some  attempt  to 
control  the  pasteurizing  of  milk  delivered  in  eight  or  ten  cities, 
which  do  practically  nothing  in  the  way  of  milk  inspection. 
Dr.  Biggs  stated  there  were  no  such  conditions  in  New  York 
State. 


214 


B.  REPORT  ON  A  SPECIAL  INVESTIGATION  OF  THE  EFFI- 
CIENCY OF  THE  NEW  YORK  GRADING  SYSTEM  IN  THE 
PRODUCING  AREA. 

Acting  on  information  from  the  Connecticut  Dairy  and  Food 
Commissioner,  that  he  had  heard  a  rumor  that  certain  milk 
dealers  in  Connecticut  were  shipping  milk  to  New  York  in  vio- 
lation of  the  New  York  City  requirements,  one  of  the  analysts 
of  the  Food  and  Drug  Division,  in  company  with  a  Connecti- 
cut dairy  inspector,  investigated  a  plant  shipping  milk  from 
Connecticut  to  New  York  City.  The  New  York  City  system 
allows  pasteurization  plants  to  be  licensed  and  ship  milk  to 
New  York.  Some  are  Grade  A  plants,  which  can  pasteurize 
and  bottle  milk  which  comes  up  to  the  New  York  requirements 
for  Grade  A  only.  A  Grade  A  plant  cannot  bottle  milk  falling 
below  those  requirements,  and  if  for  any  reason  any  dairy  ship- 
ping to  such  a  plant  falls  to  Grade  B,  the  plant  is  not  allowed 
to  handle  this  milk  with  Grade  A,  but  must  ship  it  in  cans  as 
"C"  milk  to. New  York.  In  New  York  such  milk  can  be  pas- 
teurized and  bottled  as  Grade  B. 

In  a  similar  manner  a  Grade  B  plant  cannot  bottle  milk 
under  the  Grade  A  cap.  Any  milk  coming  to  such  a  plant  to 
be  pasteurized  must  come  up  to  the  New  York  requirements 
for  Grade  B  milk.  Milk  from  Grade  A  dairies,  if  shipped  to 
a  Grade  B  plant,  must  be  put  out  from  such  a  plant  as  Grade 
B.  The  rumor  relative  to  violations  of  the  New  York  City 
milk  rules  was  that  some  plants  were  handling  both  "A"  and 
"B"  grades,  and  it  was  suspected  that  some  Grade  B  milk  was 
being  sent  to  New  York  with  Grade  A  caps. 

As  far  as  the  Connecticut  dairy  authorities  knew,  the  only 
plant  shipping  bottled  milk  to  New  York  with  Grade  A  caps 
was  Borden's  Grade  A  pasteurization  plant  at  Washington, 
Conn.  The  original  plan  of  inspection  was  to  visit  this  plant 
and  also  "some  of  the  dairies  supplying  it,  but  owing  to  a  heavy 
snow  fall  a  few  days  before,  most  of  the  roads  were  impassable 
and  train  service  uncertain,  so  the  Washington  plant  was  the 
only  place  visited.  || 

This  plant  receives  milk  from  dairies  scoring  high  enough  to 
furnish  Grade  A  under  the  New  York  requirements.     These 


215 

dairies  are  scored  twice  a  year  by  agents  of  the  New  York  City 
Board  of  Health  and  by  Borden's  inspectors  about  once  a 
month.  Sediment  tests  are  taken  frequently  at  the  plant  so 
that  the  farmer  can  see  how  his  milk  compares  with  that  of 
his  neighbors.  The  investigators  saw  about  20  sediments  from 
these  tests,  and  all  were  unusually  clean,  some  showing  no  sedi- 
ment whatever.  Samples  are  taken  for  butter-fat  tests  every 
day,  as  the  farmer's  pay  depends  on  the  grade  of  milk  plus 
the  amount  of  butter  fat,  Grade  A  milk  with  3.80  per  cent, 
fat  being  worth  4  cents  per  quart.  If  milk  shipped  to  a  Grade 
A  plant  falls  to  Grade  B  requirements,  the  shipper  must  either 
accept  a  Grade  C  price,  which  is  10  cents  per  can  less  than 
Grade  A,  or  .else  ship  to  a  plant  handling  Grade  B  milk. 

At  Washington  bottles  bearing  Grade  A  caps,  and  others 
with  Grade  B  caps,  were  seen  which  might  lead  one  to  believe 
that  this  plant  was  violating  the  regulations  by  handling  milk 
from  Grade  B  dairies.  This,  however,  was  not  the  case,  as  all 
the  milk  came  from  dairies  up  to  the  Grade  A  requirements, 
and  could  be  bottled  as  Grade  A  if  there  were  sufficient  de- 
mand for  this  grade,  which  costs  the  consumer  1  cent  per 
quart  more  than  does  Grade  B.  As  there  is  no  regulation  for- 
bidding the  selling  of  a  high-grade  milk  in  place  of  a  lower  one, 
this  plant  was  merely  selling  its  surplus  Grade  A  milk  as  Grade 
B,  for  which  there  was  plenty  of  demand. 

At  the  plant  a  record  is  kept  of  all  milk  received,  source  of 
supply,  and  amount  of  bottled  milk  sent  away  each  day,  as 
well  as  a  record  of  the  temperature  and  time  of  pasteurization. 
These  records  are  inspected  from  time  to  time  by  the  New 
York  Board  of  Health.  If  these  inspections  show  that  milk 
has  been  received  from  Grade  B  dairies,  the  plant's  license  may 
be  taken  away  and  the  milk  of  mixed  grades  may  be  destroyed. 

The  manager  of  the  Washington  plant  thought  that  the  New 
York  City  system  of  grading  milk  was  the  best  one  yet  devised, 
and  that  other  States  and  cities  would  adopt  a  similar  one. 
With  proper  inspection  of  the  dairies  and  the  records  ot  the 
plants,  there  seems  to  be  no  reason  why  a  State  or  city  could 
not  be  reasonably  sure  of  its  milk  supply.  If  a  contractor 
tried  to  evade  the  law  and  sell  low-grade  milk  for  a  higher 
one,  he  would  surely  be  caught  in  less  than  a  month,  and  lose 


216 

more  than  he  could  possibly  gain.  The  whole  system  depends 
on  proper  and  frequent  inspection  by  competent  men.  The 
only  possible  disadvantage  to  such  a  system  is  that  it  prac- 
tically forces  dairymen  to  sell  at  wholesale  rates  unless  they 
can  make  certified  milk. 

C.    REPORT  ON  A  SPECIAL  INVESTIGATION  OF  THE  NEW 
YORK  GRADING  SYSTEM  IN  THE  PRODUCING  AREA. 

On  Jan.  14  and  15,  1916,  a  representative  of  the  Massachu- 
setts State  Department  of  Health  visited  a  number  of  tarmers 
in  the  vicinity  of  Utica,  N.  Y.,  to  get  their  opinions  of  the 
present  grading  system  of  the  New  York  City  Board  of  Health 
for  the  milk  supply  of  that  city.  These  farmers  deliver  milk 
to  three  different  stations,  namely,  the  Muller  Company  of 
Marcy,  N.  Y.,  the  Harlem  Products  Company  of  Clinton,  N.  Y., 
and  the  R.  F.  Stevens  Company  of  Clinton,  N.  Y.  Two 
of  the  farmers  are  grange  masters,  and  most  of  them  grange 
members.  They  are  nearly  all  making  Grade  B,  but  a  few 
were  making  Grade  C,  milk.  None  of  them  were  producing 
Grade  A  milk. 

The  prices  paid  for  milk  were  from  $1.70  to  $1.80  per  100 
pounds  for  Grade  B  milk,  and  10  cents  per  100  pounds  less 
for  Grade  C.  In  case  of  the  Stevens  station  a  fat  percentage 
of  3.8  was  also  required  for  Grade  B,  as  well  as  the  other  New 
York  City  grading  system  requirements;  and  10  cents  per  100 
pounds  was  offered  for  every  .1  per  cent,  fat  over  3.8  per  cent. 

The  farmers  were  asked  particularly  what  objections,  if  any, 
they  had  to  the  system;  also  what  they  received  for  their  milk, 
and  if  prices  were  satisfactory,  and  if  not,  what  they  considered 
fair  prices;  whether  the  inspection  requirements  were  consistent 
with  the  prices  allowed;  whether  the  inspection  was  fair  or  too 
rigid  for  the  grade  supplied;  what  grade  of  milk  they  supplied 
and  what  determined  the  grading;  if  the  inducement  to  supply 
a  higher  grade  was  worth  the  extra  effort;  whether  the  in- 
spectors themselves  were  competent;  and  finally,  whether  the 
system  was  in  any  way  satisfactory  to  them.  Taken  individ- 
ually, their  statements  were  as  follows :  — 

1.  Mr.  A,  Marcy,  N.  Y.  —  Mr.  A  is  furnishing  Grade  C  milk.  He  re- 
ceives $1.70  per  100  pounds  of  milk.    He  said  he,  on  the  whole,  was  well 


217 

satisfied;  that  the  treatment  of  the  farmer  depended  largely  on  the  con- 
tractors; that  his  station  did  not  pay  as  well  as  some  others;  he  did  not 
care  to  retail  milk,  as  customers  were  uncertain  and  the  station  took  all 
his  product.  When  asked  why  he  did  not  get  into  a  higher  grade,  he  said 
the  scoring  requirements  would  not  put  him  there,  and  for  the  little  extra 
he  received  (10  cents  per  100  pounds)  it  was  not  worth  while. 

2.  Mr.  B,  Marcy,  N.  Y.  — ■  Mr.  B  is  furnishing  Grade  B  milk.  He  said 
at  once  that  he  was  very  much  dissatisfied ;  that  in  his  opinion  the  require- 
ments should  be  for  one  grade,  with  all  the  farmers  in  that  grade.  He  said 
most  decidedly  that  the  price  received  was  not  by  any  means  sufficient. 
He  receives  at  present  $1.80  per  100  pounds  of  milk.  Prices  varied  accord- 
ing to  season  from  $1.05  to  $1.85  per  100  pounds.  When  asked  what  he 
considered  a  fair  price,  he  said  $2  per  100  pounds  for  the  winter  months 
and  $1.50  for  the  summer  monthswould  be  satisfactory.  He  said  the  slight 
increase  in  price  for  milk  of  higher  grade  is  not  enough  to  make  it  worth 
while  producing  it.  Some  contractors  give  more  than  others;  the  farmer 
is  at  the  mercy  of  the  contractor.  The  inspectors  are  not  practical  men 
and  do  not  understand  their  work  thoroughly.  He  did  not  know  of  a 
good  point  about  the  system,  and  would  prefer  to  retail  milk,  but  had  no 
near-by  market. 

3.  Mr.  C,  Marcy,  N.  Y.  —  Mr.  C  is  furnishing  Grade  C  milk.  He 
receives  now  $1.70  per  100  pounds.  When  asked  why  he  was  in  this 
grade  he  replied  that  his  barn  was  old  and  his  score  did  not  place  him 
higher.  He  was  asked  about  bacterial  count  placing  him  in  grade,  and 
he  said  he  heard  very  little  of  this,  and  has  only  received  reports  of  bac- 
terial count  twice;  but  the  scoring  of  his  barn  was  what  placed  him  in 
Grade  C,  although  his  milk  is  clean.  He  considered  that  the  bacterial 
count  is  extremely  variable  and  uncertain,  and  often  ran  high  for  some 
unaccountable  reason;  also  thought  that  scoring  and  bacterial  count  were 
not  consistent.  He  said  also  that  he  knew  that  Grade  B  and  Grade  C 
milk  were  lixed  at  the  station;  whether  it  all  went  out  as  Grade  B  he 
was  not  certain,  but  it  was  likely  that  it  did.  He  considered  the  inspectors 
not  well  informed  or  practical.  Slightly  rusty  utensils  were  often  com- 
plained of,  yet  rusty  and  dirty  cans  often  came  to  him  from  the  station. 
When  asked  in  regard  to  prices  he  said  emphatically  that  he  did  not  re- 
ceive enough  money;  that  the  price  of  help  is  double  what  it  was  ten 
years  ago,  and  the  price  of  milk  has  gone  up  but  25  per  cent.;  $2  for  six 
winter  months  and  $1.50  for  six  summer  months  would  be  fair  prices  in 
his  opinion. 

4.  Mr.  D,  Marcy,  N.  Y.  —  Mr.  D  is  furnishing  Grade  C  milk,  and  re- 
ceives at  present  $1.70  per  100  pounds  of  milk.  In  his  opinion  his  milk  is 
as  clean  as  he  can  produce  it,  yet  his  score  holds  him  in  Grade  C.  He  has 
heard  but  twice  reports  on  bacterial  count.  The  sediment  test  is  taken 
once  a  week,  and  he  considers  this  a  good  requirement.  He  said,  more- 
over, that  clean  milk  could  be  produced  under  almost  any  surrounding 
conditions  if  cows,  utensils  and  the  farmer  himself  were  clean.  When 
asked  in  regard  to  price  he  replied  that  it  is  not  by  any  means  enough; 


218 

the  price  of  raw  material,  fodder,  etc.,  should  be  taken  into  account  when 
regulating  price  allowed  for  milk.  Three  and  one-half  to  4  cents  per 
quart  is  the  present  cost  of  producing  milk.  He  considered  that  the  farmers 
are  at  the  mercy  of  inspectors  who  do  not  know  their  business.  He  said 
that  the  farmers  are  fools  to  let  this  system  continue,  and  not  make  some 
effort  in  their  own  united  interests.  He  also  knew  that  Grade  B  and  Grade 
C  milk  were  mixed  at  the  station,  and  were  probably  sold  as  Grade  B  in 
New  York  City.1 

5.  Mrs.  E,  Marcy,  N.  Y.  —  Mrs.  E  is  producing  Grade  B  milk,  and 
gets  11.80  now  per  100  pounds  of  milk.  She  said  at  once  that  prices  were 
not  sufficient,  and  that  the  difference  in  price  for  a  grade  higher  milk  is 
not  enough  to  make  it  worth  the  extra  effort  to  produce  it.  The  grading 
in  her  opinion  is  done  entirely  by  score  card,  yet  she  received  a  report  of 
bacteria  count  once  when  it  ran  high,  which  would  perhaps  indicate  that 
this  also  has  some  influence  on  the  grading.  She  considered  the  whole 
system  in  an  unsatisfactory  condition.  A'  price  of  $2  per  100  pounds  for 
winter  months  and  $1.50  for  summer  months  would  be  fair.  She,  more- 
over, intends  to  make  cream  from  all  of  her  milk  and  sell  this  rather  than 
sell  milk  to  the  station  under  present  conditions. 

6.  Mr.  F,  Clinton,  N.  Y.  —  Mr.  F  sells  his  milk  as  Grade  B,  and  all 
milk  sold  to  this  station  is  of  that  grade.  He  is  graded,  as  far  as  he  knows, 
according  to  result  of  score  card  rather  than  bacterial  count.  He  gets  at 
present  $1.70  per  100  pounds,  and  has  received  as  low  as  $1.10  per  100 
pounds.  He  said  that  he  was  not  satisfied,  and  considers  that  $2  per  100 
pounds  for  December  and  January,  and  $1.80  to  $1.90  per  100  pounds  the 
rest  of  the  year,  would  be  a  satisfactory  price.  He  also  said  that  he  had 
heard  that  farmers  in  some  sections  were  considering  putting  up  their  own 
station  owing  to  low  prices  received.  Mr.  F  also  objected  to  the  return- 
ing of  dirty  cans  from  New  York  City  to  be  washed  at  the  station,  rather 
than  washing  them  in  New  York  City.  He  said  they  were  returned  in  an 
unusually  filthy  condition,  and  had  heard  also  that  often  garbage,  and  in 
one  instance  a  dead  cat,  had  been  found  in  one  of  the  empty  cans.  The 
writer  saw  no  evidence  of  this,  however.  Mr.  F  also  sells  some  of  his  milk 
at  retail  in  Clinton,  N.  Y.,  and  finds  this  method  yields  him  proper  returns. 

7.  Mrs.  G,  Clinton,  N.  Y.  —  Speaking  for  her  husband  she  said  he  de- 
livers to  station,  selling  on  butter-fat  basis  as  well  as  on  grading.  She  has 
heard  him  say  he  is  very  much  dissatisfied  with  prices  and  intends  selling 
his  cows. 

8.  H.  Farm,  Clinton,  N.  Y.  —  This  farm  is  producing  Grade  B  milk, 
which  is  also  sold  on  the  butter-fat  basis,  3.8  per  cent,  required  and  10 
cents  per  100  pounds  allowed  for  every  .1  per  cent,  over  this.  This  farm 
gets  now  $1.85  per  100  pounds,  and  is  not  satisfied  with  prices,  as  no  profit 
can  be  made  with  present  cost  of  labor  and  feed.  Two  dollars  for  six 
months  and  $1.50  for  six  months  per  100  pounds  would  be  a  fair  price. 
This  farm  makes  special  effort  to  have  a  clean  stable,  yet  cannot  get  into 
Grade  A  because  of  rigid  requirements. 

1  Investigations  made  elsewhere  show  this  statement  to  be  absolutely  without  foundation. 


219 

9.  Mr.  I,  Clinton,  N.  Y.  —  Mr.  I  had  gone  out  of  business  because 
prices  were  not  sufficient  to  warrant  his  selling  milk.  He  said  he  had  fig- 
ured carefully  and  found  that  milk  could  not  be  produced  on  a  paying  basis 
unless  $2.25  was  received  during  winter  months  and  $1.75  for  the  other 
six  months  per  100  pounds.  To  quote  Mr.  I:  "When  you  feel  you  are 
losing  on  every  quart  produced  you  lack  interest  and  feel  antagonized, 
especially  when  inspectors  are  visiting.  If  inspection  is  rigid,  and  it  is 
right  that  it  should  be,  the  farmer  should  get  a  price  which  is  satisfactory. 
The  New  York  Board  of  Health  should  regulate  price  paid  to  the  farmer 
as  well  as  grade  the  milk,  and  hold  him  to  the  requirements  of  his  grade." 

10.  Mr.  J,  Clinton,  N.  Y.  —  Mr.  J  sells  to  Stevens  station,  giving  price 
on  butter  fat  as  well  as  on  grade.  He  sells  Grade  B  milk  at  $1.85  per  100 
pounds  (now).  He  finds  it  hard,  and  said  others  also  do,  to  produce  milk 
above  3.8  per  cent,  fat  and  get  a  good  quantity  of  milk.  The  variance  in 
price  is  not  satisfactory,  and  the  price  at  any  time  is  not  sufficient.  Two 
dollars  in  winter  and  $1.75  per  100  pounds  in  summer  would  be  fair.  Help 
is  scarce  and  labor  is  high  because  hands  will  not  work  as  many  hours  as 
formerly.  Mr.  J  also  stated  that  Grades  B  and  C  are  mixed  at  the  station; 
whether  it  is  all  sold  as  Grade  B  is  not  proved.  He  considered  that  the 
system  is  not  well  supervised  at  the  station.  It  is  his  opinion  that  the 
grading  results  more  from  the  scoring  than  on  the  bacteria  count. 

11.  Mr.  K,  Clinton,  N.  Y.  —  Mr.  K  objected  to  the  same  price  being 
given  to  farmers  whose  buildings  were  in  bad  condition  as  to  one  whose 
buildings  are  well  kept.  He  sells  Grade  B  milk.  At  present  prices  he 
cannot  afford  to  hire  help  and  buy  feed;  he  therefore  does  all  the  work 
himself.  The  cost  of  feed  has  made  a  large  advance  in  the  last  ten  years. 
Mr.  K  also  does  not  consider  it  fair  to  reduce  the  price  in  March  or  April, 
which  is  done,  when  it  costs  exactly  as  much  to  feed  the  cows,  and  the  flow 
of  milk  is  no  greater  at  this  season.  As  an  example  of  the  actual  profit  he 
gets  he  said  it  costs  him  $50  a  month  to  feed  9  cows,  and  his  receipts  for 
the  sale  of  milk  were  $110,  not  counting  the  cost  of  hay  which  he  raised 
himself.  If  he  hired  help  he  would  have  little  profit  left  from  his  milk 
business.  Mr.  K  also  considered  that  the  requirement  for  cooling  morn- 
ing milk  to  60°  F.  was  a  hardship  for  the  farmer,  as  his  facilities  were  not 
as  good  for  cooling  as  those  at  the  station,  especially  when  the  morning 
milk  could  be  taken  immediately  to  the  station  without  cooling.  Regard- 
ing the  inspectors  themselves,  he  said  they  are  often  not  practical  men. 
He  told  of  one  inspector  who  visited  a  farm  where  the  cows  were  in  a 
basement  not  easily  found.  The  farmer  found  him  in  the  hayloft  looking 
for  the  cows.    Naturally,  all  respect  for  the  inspector  was  lost  at  once. 

12.  Mr.  L,  Clinton,  N.  Y.  —  Mr.  L  said  at  once  and  emphatically  that 
the  price  received  was  not  sufficient,  and  that  he  intended  to  go  out  of 
business.  He  sells  Grade  B  milk.  He  said  there  was  not  enough  induce- 
ment to  produce  better  milk. 

13.  Mr.  N,  Clinton,  N.  Y.  —  Mr.  N  is  not  selling  to  a  station,  as  he 
found  it  more  profitable  to  make  butter.  When  asked  why  some  of  the 
farmers  did  not  produce  Grade  A  milk  he  said  that  the  requirements  were 


220 

too  rigid;  even  when  the  stable  is  clean  and  produces  a  very  satisfactory 
product,  still  more  is  required,  and  the  farmers  will  not  meet  the  demands. 
He  said  the  butter-fat  premiums  are  not  regular  and  are  lowered  without 
reason,  perhaps  due  to  a  large  quantity  of  milk  on  hand.  Tests  for  butter 
fat  made  at  the  station  do  not  always  agree  with  those  made  by  State 
inspectors. 

It  appears  from  the  reports  obtained  from  these  farmers  that 
the  main  objection  regarding  the  New  York  City  system  is  one 
of  price.  They  do  not  get  enough  money  to  make  the  business 
pay.  With  one  exception,  the  farmers  were  very  much  dis- 
satisfied with  the  system.  This  man  had  been  in  this  country 
but  a  comparatively  short  time,  and  was  doubtless  more  easily 
contented,  especially  with  prices,  than  an  American  farmer  who 
would  be  in  a  position  for  better  judgment.  They  state  that 
the  requirements,  especially  for  Grade  A,  are  so  rigid  as  com- 
pared with  the  price  offered  for  the  extra  effort  that  they  do 
not  consider  it  worth  while  getting  into  a  higher  grade.  They 
claim  that  the  inspectors  themselves  are  often  not  competent, 
or  if  competent  are  not  practical  in  their  recommendations. 
It  further  appears  from  this  investigation  that  there  is  a  dif- 
ference in  the  price  paid  for  milk  of  different  grades.  There  is 
no  possibility  of  a  producer  making  a  low  grade  of  milk  and 
selling  it  for  a  higher  grade. 


D.    COPY  OF  AN  AETICLE  BY  LUCIUS  P.  BROWN    OF  THE 
NEW  YORK  CITY  HEALTH  DEPARTMENT. 

Conclusion  and  Summary. 

1.  In  a  city  of  large  size  it  is  impossible  to  so  safeguard  a 
milk  supply  confined  to  raw  milk  only,  at  any  reasonable  cost, 
as  to  insure  its  absolute  safety. 

2.  The  present  system  of  milk  control  in  New  York  City 
has  justified  itself  by  the  absence  of  any  considerable  milk- 
borne  epidemic  of  typhoid  or  other  disease  within  the  past  two 
years,  and  by  the  ease  with  which  any  epidemic  appearing  can 
be  now  traced  and  controlled. 

3.  The  New  York  system  of  milk  control  is  necessarily  a 
growth  of  many  years,  and  is  a  development  proceeding  pari 
passu  with  the  growth  of  knowledge  in  preventive  medicine, 


221 

and  particularly  in  knowledge  of  the  principles  of  pasteuriza- 
tion. 

4.  The  essential  features  of  the  New  York  City  milk  control 
system  are  — 

(a)  Pasteurization  of  all  milk  except  that  intended  for  special 
uses. 

(6)  In  connection  therewith  bacteriologic  standards  properly 
administered. 

(c)  The  labeling  of  all  packages  intended  to  go  to  the  con- 
sumer. 

(d)  Constant  inspection  and  supervision  of  the  pasteurizing 
plants,  which  is  an  inspection  that  it  is  physically  and  econom- 
ically possible  to  make  efficient,  in  direct  contrast  with  the 
attempt  to  handle  an  enormously  large  number  of  dairies  and 
their  employees,  —  a  thing  which  can  be  done  efficiently  only 
at  prohibitive  cost. 

To  thoroughly  understand  the  situation  in  New  York  City 
a  short  statement  of  the  problem  is  desirable. 

This  problem  is  as  follows:  The  control,  both  chemical  and 
sanitary,  of  a  milk  supply  for  a  city  of  about  5,000,000  people, 
with  the  aim  not  only  of  avoiding  raising  the  cost  of  the  milk,  but, 
if  possible,  of  actually  extending  its  use  as  a  cheap  and  easily 
digested  food.  Analysis  of  the  milk  supply  shows  that  about 
2,750,000  quarts  of  milk  (including  ice  cream  and  condensed 
milk)  are  consumed  daily  in  the  city,  furnished  by  7  States  and 
by  2  provinces  in  the  Dominion  of  Canada. 

It  is  estimated  that  about  50,000  dairies,  about  440,000  cows 
and  about  300,000  people  are  employed.  This  milk  supply  is 
handled  in  60  city  and  436  country  pasteurizing  plants,  and 
there  are  700  shipping  stations  for  milk  shipped  raw  to  the 
city  pasteurizing  plants.  The  longest  haul  upon  milk  coming 
to  New  York  is  about  460  miles,  and  80  per  cent,  of  it  over  200 
miles. 

The  machinery  at  hand  for  controlling  the  milk  supply  is,  of 
course,  that  under  the  control  of  the  city  Board  of  Health. 
Under  the  Constitution  of  New  York  State,  and  charter  of 
New  York  City,  the  ordinances  of  this  Board  have  the  effect 
of  laws;  its  powers  are  absolute  and  very  broad,  being  limited 
only  by  the  disposition  of  the  city's  financial  boards  to  appro- 


222 

priate  the  funds  necessary  for  the  enforcement  of  the  laws  made 
by  the  Board  of  Health. 

Following  is  a  statement  of  the  chief  successive  steps  taken 
for  the  control  of  New  York  City's  milk  supply,  which  have 
led  up  to  the  system  now  in  effect.  The  first  step  taken  was 
in  1873,  when  "swill"  milk  was  forbidden.  In  1876  a  code 
section  was  passed  by  the  Board  of  Health  forbidding  watered 
milk.  In  this  control,  however,  only  the  well-known  lactometer 
of  the  New  York  City  Board  of  Health  was  used.  The  pro- 
ducers finally  learned  how  to  beat  this  lactometer,  and  in  1895 
chemical  standards  were  set. 

In  1897  a  permit  system  was  inaugurated  for  wagons  and 
milk  stores.  In  1900  the  cooling  of  milk  in  transit  was  begun, 
and  there  has  been  progressive  improvement  in  this  particular 
feature  since  that  time.  In  1902  one  milk  inspector  was  sent 
to  the  country  to  examine  the  sources  of  supply.  In  1904  the 
milk  inspection  work,  which  was  formerly  done  by  the  separate 
boroughs,  was  centralized  in  the  hands  of  the  city  Board  of 
Health,  and  a  regulation  was  made  that  all  milk  must  be  kept, 
while  in  process  of  shipment  or  sale,  at  a  temperature  not  greater 
than  50°  F.  In  1905  a  systematic  inspection  of  creameries  was 
begun,  and  certain  deficient  ones  were  forced  out  of  business. 
In  1906  the  two  inspectors  then  at  work  began  the  inspections 
of  the  dairy  farms  proper,  and  16  new  inspectors  were  added. 
Rules  and  regulations  for  the  guidance  of  dairymen  were  made; 
and  these  appear  to  have  been  very  well  received  by  the  dairy- 
man, because  of  the  help  it  gave  him  in  regulating  his  own 
business.  In  1907  a  beginning  of  the  exclusion  system  was 
made,  the  requirements  being  that  weekly  reports  be  made  by 
creamery  men  and  dairymen  of  contagious  diseases  occurring 
in  their  establishments,  and  they  were  required  to  cease  han- 
dling their  milk  on  occurrence  of  any  such  diseases.  Failure 
to  comply  with  this  regulation  meant  the  exclusion  of  their 
milk  from  the  city.  This  principle  was  afterwards  applied  to 
other  conditions.  Milk  stores  were  likewise  regulated  as  to 
sanitary  condition,  and  the  score  card  system  was  adopted. 
A  notable  occurrence  during  this  year  was  the  appointment 
of  the  McClellan  Commission  of  Physicians,  in  the  report  of 
which  it  was  recommended  that  100  country  and  40  city  in- 


223 

spectors  be  appointed.  It  will  be  noted  that  up  to  this  time 
all  the  regulations  were  designed  towards  the  securing  of  a  sat- 
isfactory raw  milk  supply.  In  1908  the  first  notice  in  the  way 
of  an  official  pasteurization  was  made.  This  regulated  pas- 
teurization, which  had  to  be  conducted  under  permit.  During 
the  same  year  the  exclusion  system  was  extended  to  unsani- 
tary conditions  at  the  creameries  and  dairies,  and  the  wagon 
permits  were  made  conditional  on  satisfactory  report  of  con- 
ditions of  production  and  distribution.  Likewise  in  this  year 
the  classification  of  milk  appears  to  have  been  first  made.  It 
was  graded  into  selected,  inspected,  guaranteed  and  certified, 
all  conditioned  on  inspection  by  medical  societies  and  in  ac- 
cord with  regulations  of  the  Board  of  Health,  taking  cogni- 
zance of  conditions  of  the  cows,  bacterial  count,  time  of  deliv- 
ery, etc.  Pasteurized  milk  was  allowed  to  be  sold  under  permit, 
and  there  were  supplementary  regulations  on  pasteurization 
passed. 

The  most  notable  occurrence  of  this  year  was  the  require- 
ment that  there  should  be  attached  to  the  container  which 
reached  the  consumer,  or  from  which  the  consumer,  in  the 
case  of  loose  milk,  was  served,  a  tag  indicating  the  location  of 
the  dairy  or  creamery  and  the  date  of  shipment.  In  1909  pas- 
teurized milk  was  defined,  and  it  was  provided  that  the  tags 
above  mentioned  must  be  kept  for  two  months. 

It  will  be  noted  that  still  up  to  this  time  little  notice  had 
been  taken  of  pasteurization,  but  in  1910  a  Board  resolution 
(not  having  the  direct  effect  of  law)  was  passed,  advising  the 
public  that  all  milk  for  drinking  should  be  either  boiled  or 
pasteurized,  and  a  tentative  plan  for  grading  was  made  based 
on  the  broad  division  of  — 

(a)  Milk  for  infants  to  drink. 

(b)  Milk  for  adults  to  drink. 

(c)  Milk  for  cooking  only. 

These  still  form  the  broad,  general  basis  for  grading. 

In  1911  announcement  was  made  that  after  Jan.  1,  1912,  all 
milk  except  special  high-grade  milk  was  to  be  pasteurized.  The 
warning  of  this  contemplated  action  was  given  so  far  ahead 
because  of  the  necessity  of  making  changes  in  the  plants  of 
milk  dealers. 


224 

At  the  end  of  1911  there  was  a  conference  participated  in  by 
dealers,  the  New  York  Milk  Committee,  the  officials  of  the 
Department  and  certain  physicians,  which  assumed  that  in 
addition  to  pasteurized  milk  two  grades  of  raw  milk,  one  for 
children  and  one  for  adults,  could  be  sold,  based  on  prescribed 
tests  for  tuberculosis  in  cows.  These  rules  went  into  effect  in 
1912,  and  are  indicated  in  table  on  page  228.  This  step  was 
enabled  by  the  advance  of  knowledge  as  to  pasteurization,  and, 
as  will  be  seen,  by  recognition  of  the  impossibility  of  properly 
inspecting  a  raw  milk  supply  of  this  size.  It  was  in  no  sense  a 
backward  step.  In  the  year  1913,  from  the  outbreak  of  a  very 
bad  milk-borne  typhoid  epidemic  (1,100  cases  in  all),  there 
resulted  the  abolition  of  Grade  B  raw  milk,  the  pasteurization 
of  all  milk  of  this  grade,  and  the  establishment  of  bacteriologic 
standards  throughout.  There  resulted  likewise  the  simplifying 
of  Grade  A  and  the  inclusion  of  cream  in  the  pasteurization 
requirements. 

This  summary  gives  some  indication  of  the  weary  road  trav- 
ersed by  those  men  to  whom  is  due  the  credit  for  the  present 
excellent  supply  of  milk  for  New  York  City.  It  will  be  noted 
that  the  essential  features  are  pasteurization  almost  exclusively, 
and  bacteriologic  control  of  the  raw  and  pasteurized  milk,  ex- 
cept in  Grade  A.  It  will  be  noted  from  table  on  page  229  that 
dairy  scores  are  still  used  to  assist  in  controlling  the  farms. 
This  in  no  sense  allows  of  the  pasteurization  of  dirty  milk.  As 
a  matter  of  fact,  as  is  well  known  to  those  having  to  do  with 
milk  control,  dirty  dairies  with  their  concomitant  of  careless 
and  dirty  methods  almost  invariably  produce  dirty  work,  while 
on  the  other  hand  the  clean  dairy  produces  clean  milk.  Be- 
cause of  this  human  factor  a  fair  control  of  the  condition  of 
Grade  B  dairies  may  be  effected  through  the  bacteriologic  ex- 
amination of  the  milk.  Grade  A,  which  is  naturally  that  milk 
requiring  more  supervision,  is,  of  course,  designed  for  the  use 
of  children,  and  must  be,  therefore,  absolutely  above  suspicion. 
By  requiring  that  no  milk  of  a  lower  grade  than  "A"  be  han- 
dled in  a  Grade  A  plant,  the  necessary  distinction  as  to  that 
grade  is  readily  secured.  Mr.  Russel  Sturgis,  chief  of  the 
Milk  Division,  of  the  Bureau  of  Food  and  Drugs  of  the  Health 
Department  of  New  York  City,  in  an  excellent  paper  published 


225 

in  1915,  on  "The  Role  of  Dairy  Inspection  in  Safeguarding  a 
City's  Milk  Supply,"  and  to  which  I  am  indebted  for  a  very 
large  part  of  what  I  have  been  saying,  suggests  that  possibly 
at  some  future  time,  when  the  private  inspection  systems  of 
the  milk  companies  have  been  more  completely  developed,  it 
will  be  found  that  the  score  card  standard,  at  present  neglected, 
will  be  appreciated  as  a  measure  of  value.  As  a  matter  of 
actual  fact,  all  companies  handling  milk  desire  of  course  to 
furnish  Grade  A  milk,  selling  for  the  highest  price.  They  there- 
fore pay  the  farmer  a  premium  for  clean  dairies  and  clean  milk, 
and  this  operates  as  an  incentive  to  the  producer  to  improve 
his  conditions. 

It  has  often  been  objected  to  pasteurization,  in  the  language 
of  certain  gentlemen  of  florid  imagination,  that  the  sale  of  pas- 
teurized milk  containing  dead  organisms  —  a  sort  of  bacteria 
soup  —  is  strictly  parallel  to  the  sale  of  a  milk  soup  made  from 
oysters  -of  an  uncertain  vintage.  I  think  experience  hardly  sus- 
tains this  violent  assumption.  Whether  it  be  true  or  not,  how- 
ever, the  impossibility  of  handling  a  very  large  milk  supply, 
such  as  that  for  the  city  of  New  York,  without  prohibitive  cost 
for  inspection,  as  well  as  without  raising  the  cost  of  raw  milk  to 
the  consumer  to  a  prohibitive  figure,  can  be  readily  appreci  ited. 
Moreover,  a  raw  milk  supply  of  this  size  which  is  absolutely 
safe  is  a  matter  of  practical  impossibility  under  present  con- 
ditions; if  for  no  other  reason,  because  of  the  absolute  impos- 
sibility of  keeping  out,  in  the  enormous  number  of  people 
through  whose  hands  the  milk  supply  goes  before  reaching  the 
consumer,  carrier  cases  of  typhoid,  diphtheria  and  the  like. 

In  addition  to  the  occasional  farm  inspection  by  the  Depart- 
ment, farm  inspection  is  promoted  on  the  part  of  the  companies 
by  the  necessary  connection  of  conditions  indicated  by  our  in- 
spections and  counts,  by  the  efforts  of  small  companies  trying 
to  remedy  faults,  and  by  dairymen  who  are  trying  for  the  pre- 
miums for  high  dairy  scores  given  by  the  companies.  It  may 
be  further  added  that  prior  to  1912,  and  the  inception  of  this 
system  of  milk  control,  one  or  more  typhoid  outbreaks  every 
year  in  New  York  City  which  could  be  directly  fastened  on 
the  milk  supply  were  the  rule,  and  usually  these  were  of  very 
considerable  size. 


226 

In  1914  and  1915  there  has  up  to  date  been  only  one  small 
milk-borne  epidemic  of  typhoid,  promptly  stopped  by  shutting 
off  the  milk  supply,  and  only  90  direct  cases  in  all.  This  oc- 
curred in  a  pasteurized  supply,  and  appears  to  have  been  due 
either  to  a  carrier  case  handling  the  milk  after  pasteurization, 
or,  much  more  probably,  to  the  water  supply  of  the  creamery 
becoming  suddenly  polluted. 

A  short  description  of  the  methods  used  by  the  Department 
may  be  of  interest.  It  is  required  that  the  pasteurization  be 
conducted  between  142°  F.  and  145°  F.  for  not  less  than  thirty 
minutes;  and,  of  course,  cooling  after  pasteurization  must  be 
very  prompt.  In  making  his  inspection  the  operator,  of  course, 
carefully  examines  all  pipes  and  connections  from  pumps  and 
other  apparatus,  taking  everything  apart  if  necessary  to  assure 
himself  of  cleanliness.  He  watches  the  sterilizing  of  the  pipes 
and  vats  before  use.  In  the  actual  handling  of  the  milk  he 
notes  its  condition  as  to  dirt  upon  receipt,  and  watches  to  see 
that  it  is  not  exposed  to  dust.  If  the  automatic  temperature 
recorder  is  used  its  accuracy  is  tested  at  each  inspection.  These 
recording  devices  indicate  the  holding  period  very  well  except 
in  case  of  continuous  retarders,  and  in  this  type  of  apparatus 
the  holding  period  is  best  ascertained  by  watching  the  speed 
at  which  the  milk  is  dumped  through.  It  is  cooled,  preferably 
to  45°  or  lower,  and  then  the  milk  is  immediately  bottled  or 
canned  for  shipment.  By  taking  the  temperature  of  cooling  at 
frequent  intervals  the  inspector  is  able  to  advise  whether  the 
hot  milk  is  fed  to  the  cooler  too  fast  to  obtain  good  results. 
Special  stress  is  laid  on  the  cleanliness  of  bottles  and  cans  used 
for  holding  pasteurized  milk.  For  this  a  sterile  water  control 
is  used  in  the  bacteriologic  examination,  and  inspectors  are 
kept  closely  informed  of  all  results,  their  personal  effort  being 
of  great  value  in  this  connection.  Water  samples  for  this  pur- 
pose are  transmitted  to  the  laboratory  for  a  count  in  the  same 
way  as  the  milk  samples,  50  cubic  centimeters  of  sterile  water 
being  used  for  washing  each  can  or  bottle.  The  accepted  stand- 
ard is  1,000  total  bacteria  in  each  50  cubic  centimeters  so 
treated  for  bottles  and  10,000  for  cans. 

Schedules  for  inspection  are  so  arranged  that  samples  of  milk 
are  taken  during  inspection  of  pasteurizing  plants  at  certain 


227 

intervals.     I  quote  from  Sturgis's  paper  previously  mentioned, 
as  follows :  — 

Four  samples  are  taken  at  each  of  the  various  steps,  and  from  those 
four  individual  samples  an  average  is  obtained  which  fairly  reflects  the 
quantity  of  the  milk  and  also  serves  as  a  check  upon  the  thoroughness  of 
pasteurization.  Usually  these  samples  are  taken  from  (a)  the  raw  milk; 
(6)  at  the  outlet  of  the  holder,  or  after  the  milk  has  been  heated  and  held; 
(c)  from  the  outlet  of  the  cooler;  (d)  from  bottles  or  cans  that  have  been 
filled  for  shipment.  These  samples  are  thoroughly  chilled,  packed  in  ice, 
and  shipped  in  the  milk  car  to  the  city  terminal,  where  they  are  collected 
upon  arrival  and  taken  to  the  laboratory. 

Our  present  inspection  force  consists  of  20  country  inspectors 
and  12  city  inspectors.  The  country  inspector's  duty  consists 
in  the  inspection  of  plants  as  just  mentioned,  and  of  dairies. 
Grade  A  dairies  are  inspected  three  times  a  year,  and  as  much 
oftener  as  possible.  Other  dairies  are  inspected  when  the  occa- 
sion allows.  All  inspections  of  dairies  and  creameries  are  re- 
corded on  score  cards  of  the  New  York  City  form,  the  dairy 
cards  being  made  in  duplicate  and  a  copy  left  at  the  farm. 
The  pasteurizing  plants  are  not  scored,  but  are  recorded  on  a 
special  card  where  only  changes  from  the  last  inspection  are 
noted.  This  is  also  in  duplicate,  but  the  copy  is  sent  to  the 
office,  and  from  there  sent  to  the  company  responsible  instead 
of  being  left  direct  with  the  company.  On  occasion  the  epi- 
demiology of  suspected  milk-borne  diseases  is  investigated  by 
these  country  inspectors. 

The  city  inspectors  watch  the  supply  to  the  point  of  delivery, 
that  is  to  say,  either  to  the  retail  store  or  to  the  customer. 
The  stores  themselves  are  inspected  by  inspectors  of  the  Food 
Division  of  the  Bureau  of  Food  and  Drugs,  avoiding  in  this 
way  duplication  of  work.  Of  the  12  city  milk  inspectors  at- 
tached to  the  Division  of  Milk  Inspection  3  are  on  bacteria  sam- 
ples, 5  on  samples  for  chemical  analysis,  2  on  pasteurizing  plants 
alone,  and  2  on  the  large  city  dairies  and  on  the  pasteurizing  plants 
in  outlying  portions.  It  is  interesting  to  note  here  that  within 
the  city  of  New  York  itself  there  are  over  100  dairies,  with 
about  5,000  cows.  Each  of  the  bacteria  squad  takes  68  samples 
daily  of  raw  milk  going  to  pasteurizing  plants,  or  of  the  pas- 
teurized milk  as  offered  for  sale,  making,  all  told  (including  40 


228 

samples  each  for  the  two  men  on  the  pasteurizing  plants),  284 
samples  of  milk  taken  in  the  city  for  bacterial  examination 
daily.  A  list  of  the  various  supplies  is  furnished  to  each  man, 
and  it  is  estimated  that  he  will  cover  his  field  in  three  to  four 
weeks.  The  chemical  squad  takes  samples  from  wagons,  about 
65  a  week  in  all.  It  will  thus  be  noted  that  from  1,600  to 
1,800  samples  for  bacteriologic  and  chemical  analysis  are  taken 
per  week  for  milk  inspection  purposes. 

It  is  proper  to  state  that  for  a  considerable  portion  of  the 
information  given  in  this  paper  I  am  indebted  to  a  monograph 
bearing  the  name  of  Lederle  &  Raynor,  published  by  the  De- 
partment of  Health,  and  to  the  paper  by  Russel  Sturgis,  chief 
of  the  Division  of  Milk  Inspection,  heretofore  alluded  to. 

It  is  perhaps  unnecessary  for  me  to  state  that  my  recent 
connection  with  the  New  York  City  Health  Department  has 
made  it  impossible  for  me  to  prepare  this  paper  without  much 
help  from  others. 

1912. 

Grade  A. 

1.  Certified  or  guaranteed. 

2.  Inspected  raw. 

Dairies:  — 

Equipment, 25 

Methods, 50 

Bacteria :  — 
60,000  per  cubic  centimeter. 

3.  Selected  pasteurized. 

Dairies:  — 

Equipment, 20 

Methods, 40 

Bacteria :  — 

200,000  per  cubic  centimeter  before  pasteurizing. 

50,000  per  cubic  centimeter  after  pasteurizing. 

Grade  B. 

1.  Selected  raw. 

Dairies :  — 

Equipment, 25 

Methods, 43 

Bacteria  shall  not  be  excessive. 

2.  Pasteurized. 

No  dairy  standard. 
No  bacteria  standard. 


229 


Grade  C. 
For  cooking  fat  first  allowed  raw). 
Later  required  heated  or  pasteurized  (no  standards). 

1914. 

Grade  A. 

1.  Raw. 

Dairies :  — 

Equipment, 25 

Methods, ' 50 

Bacteria:  — 
60,000  per  cubic  centimeter. 

2.  Pasteurized. 

Dairies :  — 

Equipment, 25 

Methods, 43 

Bacteria:  — 

200,000  per  cubic  centimeter  before  pasteurizing. 

30,000  per  cubic  centimeter  after  pasteurizing. 

Grade  B. 
Pasteurized. 
Dairies: x  — 

Equipment, 20 

Methods, 35 

Bacteria:  — 

1,500,000  per  cubic  centimeter  before  pasteurizing  in  city. 
300,000  per  cubic  centimeter  before  pasteurizing  in  country. ' 
100,000  per  cubic  centimeter  after  pasteurizing. 

Grade  C. 
Pasteurized. 
Dairies :  — 
Total, 40 

Bacteria:. — 

300,000  per  cubic  centimeter. 

1  At  present  not  enforced. 


230 


E.  REPORT  ON  INFORMATION  GATHERED  AT  THE  CON- 
VENTION OF  THE  INTERNATIONAL  MILK  INSPECTORS 
ASSOCIATION. 

The  following  information  was  obtained  from  the  lectures  and 
from  talking  with  various  local  inspectors :  — 

Cumberland,  Md.  —  All  the  milk  comes  from  near  home,  within  30  miles. 
About  one-half  the  supply  is  pasteurized  and  is  not  from  tuberculin-tested 
cows.  The  standard  is  12.50  per  cent,  solids,  3.50  per  cent.  fat.  The  price 
is  9  cents  retail  and  about  4  cents  wholesale. 

Detroit,  Mich.  —  Supply  comes  from  within  100  miles,  and  all  has  to 
be  pasteurized,  but  does  not  come  from  tuberculin-tested  cows.  The 
standard  is  12.50  per  cent,  solids,  3  per  cent.  fat. 

Seattle,  Wash.  —  The  supply  comes  from  within  90  miles,  and  has  to  be 
either  pasteurized  or  from  tuberculin-tested  cows.  The  standard  is  3.25 
per  cent,  fat  and  not  over  200,000  bacteria.  The  wholesale  price  is  16 
cents  per  gallon,  and  the  retail  price  is  9  cents  per  quart.  The  United 
States  score  card  is  used  and  is  relied  upon  absolutely.  All  employees  in 
pasteurization  plants  have  to  be  examined  to  see  that  they  are  not  disease 
carriers. 

Manchester,  N.  H.  —  Nearly  all  the  milk  comes  from  near  home,  though 
a  little  comes  200  miles.  Some  is  pasteurized.  It  is  not  from  tuberculin- 
tested  cows.  Retail  price  is  8  cents  per  quart,  while  the  farmer  received 
3  to  5  cents  per  quart. 

Washington,  D.  C.  —  In  1872  the  Washington  Board  of  Health  re- 
quired a  permit  for  milk  to  come  to  the  District  from  the  surrounding 
country,  but  in  1884  this  was  stopped.  In  1892  the  Sanitary  League  was 
formed;  and  obtained  a  law  compelling  inspection  before  granting  permits. 
This  law  was  passed  in  1895.  This  was  the  first  system  of  licensing  and 
controlling  the  milk  supply,  and  is  the  one  still  used  in  Washington.  Con- 
gress passes  the  milk  law  for  the  District  of  Columbia.  The  standard  is 
12.50  per  cent,  solids  and  3.50  per  cent.  fat.  All  cattle  have  to  be  tuber- 
culin tested. 

Norjolk,  Va.  —  Supply  all  raised  within  7  miles,  and  about  40  per  cent. 
is  pasteurized  and  has  to  be  from  tuberculin-tested  cows.  Retail  price  is 
10  cents.  There  is  not  much  wholesale  milk,  but  the  price  is  about  20 
to  23  cents  per  gallon.  The  fat  standard  is  3  per  cent.,  and  the  inspector 
would  prosecute  below  this  figure.  Certified  milk  must  not  contain  over 
10,000  bacteria.  The  inspector  likes  the  United  States  score  card.  He 
does  not  believe  in  milking  machines,  as  they  spoil  the  cow. 

New  York.  —  The  State  standard  and  methods  are  used  by  all  local 
inspectors  except  in  cases  where  the  cities  or  towns  make  regulations  more 
drastic  than  that  of  the  State.  All  milk  has  to  be  from  tuberculin-tested 
cows  or  be  pasteurized.    Standard  is  11.25  per  cent,  solids  and  3  per  cent. 


231 

fat.  Milk  is  graded  A,  B  and  C  raw  and  A,  B  and  C  pasteurized.  For  A 
raw  milk  the  farmer  must  score  at  least  75,  and  the  milk  contain  not  over 
30,000  bacteria.  Herd  must  be  examined  each  year.  The  score  must  be 
at  least  25  for  equipment  and  43  for  methods. 

Grade  B :  Bacteria  not  over  200,000.  Score  must  be  23  for  equipment 
and  37  for  methods,  and  herd  must  be  examined  each  year. 

Grade  B,  pasteurized:  Score  must  be  20  for  equipment  and  35  for 
methods,  bacteria  not  over  1,000,000,  and  the  herd  must  be  tested  each 
year. 

Grade  C  is  anything  from  dairies  scoring  40  points,  but  local  authorities 
may  make  special  regulations. 

Grade  A  pasteurized  must  not  contain  over  200,000  bacteria  before 
pasteurization. 

The  farmer  receives  3J  to  4  cents  for  A  pasteurized  grade,  but  for  B 
grade  is  paid  on  a  fat  basis,  which  is  lower.  Retail  price  of  A  pasteurized 
and  raw  is  the  same,  but  most  people  prefer  raw  milk.  About  one-third 
of  the  milk  is  pasteurized  by  heating  to  145°  and  holding  thirty  minutes. 
Heating  too  high  breaks  the  cream  line  and  spoils  the  looks  of  the  milk. 

Most  of  this  information  was  obtained  from  the  Auburn,  N.  Y., 
inspector. 

In  case  of  an  epidemic  the  health  officer  notifies  the  State  Health  De- 
partment by  telephone  or  telegraph.  The  State  Department  notifies  the 
local  authorities  to  shut  off  the  supply,  and  it  is  done  at  once.  The  score 
card  used  in  New  York  is  a  State  one,  but  is  a  good  deal  like  the  United 
States  card. 

Mr.  Purrington  of  New  Hampshire  says  in  New  Hampshire 
the  milk  business  is  a  side  issue,  and  the  farmer  generally 
peddles  his  milk  himself  instead  of  selling  to  large  dealers.  He 
usually  has  a  poor  equipment  and  cannot  afford  to  pasteurize. 
Mr.  Purrington  does  not  believe  the  State  has  any  right  to  give 
definite  orders,  provided  the  milk  is  low  in  bacteria.  The  score 
should  not  be  relied  upon  as  much  as  bacterial  count.  Twenty 
per  cent,  of  the  cattle  in  New  Hampshire  have  tuberculosis, 
and  the  tuberculin  test  is  not  general.  The  State  is  encourag- 
ing "inspected  milk."  This  is  milk  inspected  and  licensed  by 
the  State,  and  the  license  can  be  revoked.  Dealers  producing 
"inspected  milk"  are  allowed  a  special  cap  with  the  State  Seal 
upon  it,  and  receive  1  cent  per  quart  above  the  regular  price. 
About  20  producers  raise  "inspected  milk."  Prices  of  milk  are 
7,  8  and  9  cents. 

Tests  are  now  being  made  to  determine  the  cost  of  producing 
"inspected  milk." 


232 

Dr.  Wiley  says  that  where  dairy  interests  control,  the  stand- 
ard is  low.  Illinois  has  a  low  fat  standard,  —  3  per  cent.  He 
claims  that  New  York  and  Ohio  have  much  tuberculosis,  as 
farmers  are  in  control  of  Legislature  and  do  not  have  proper 
inspection.  Virginia  has  an  inspection  law,  but  not  enough 
money  to  pay  for  condemned  cows.  He  believes  the  United 
States  should  help  States  who  try  to  stamp  out  tuberculosis. 
He  believes  milk  should  be  graded,  and  the  higher  grade  should 
receive  the  best  price. 

Dr.  States  of  Detroit  believes  that  all  milk  and  its  products 
should  be  pasteurized.  He  claims  that  heating  to  160°  for 
thirty  minutes  will  kill  the  germs. 

Professor  Stocking  of  Cornell  says  that  only  a  small  propor- 
tion of  milk  drinkers  get  diseases  from  milk,  but  believes  all 
this  is  preventable. 

Mr.  T.  of  Washington,  D.  C,  a  milk  dealer  who  lost  his  license, 
does  not  believe  pasteurization  kills  germs  of  tuberculosis. 

The  general  opinion  of  those  with  whom  the  representative 
talked  and  the  speakers  was  that  all  milk  should  be  pasteurized, 
though  some  believed  that  milk  from  tuberculin-tested  cows 
was  safe  if  consumed  raw.  Dairy  inspection  and  the  use  of  the 
United  States  score  card  were  recommended,  although  the  score 
card  should  not  be  used  as  a  standard  for  judging  the  milk,  the 
bacterial  count  being  more  important.  Mississippi  and  Wash- 
ington do  not  allow  disease  carriers  or  those  recently  having 
disease  to  handle  milk,  and  Seattle  requires  Widal  tests  from 
all  employees  in  dairies.  Montclair  requires  a  health  certificate 
every  three  months  for  employees  in  plants  where  milk  is  not 
pasteurized. 

Mr.  Stephenson  of  Washington,  D.  C,  believes  in  milking 
machines  where  labor  is  scarce,  but  thinks  it  takes  experienced 
men  to  use  them.  They  do  not  pay  for  less  than  20  cows.  No 
special  mention  was  made  regarding  different  kinds  of  machines. 
One  or  two- men  believed  in  the  use  of  clarifiers,  though  the  use 
of  them  usually  increased  the  number  of  bacteria. 

No  one  knew  of  any  portable  forms  of  pasteurizers  or  cheap 
forms  for  small  dealers.  Co-operative  or  city  plants  were  sug- 
gested, or  the  use  of  a  wash  boiler,  as  a  cheap  form  of  pas- 
teurizer, in  the  home  in  case  of  epidemics. 


233 

The  need  of  pasteurization  or  tuberculin-tested  cattle  and 
the  medical  inspection  of  employees  in  dairy  plants  were  gen- 
erally agreed  upon,  though  the  additional  cost  of  the  milk  and 
the  driving  of  small  dealers  from  business  were  reasons  ad- 
vanced against  these  ideas.  The  United  States  score  card 
seems  to  be  considered  the  best  standard  there  is  for  dairy 
inspection,  and  no  changes  were  suggested. 

F.    DIGEST  OF  RECENT  AMERICAN  MILK  LEGISLATION  BY 
VARIOUS  CITIES  AND  STATES. 

The  following  milk  laws  and  regulations  were  taken  from 
the  bulletins  of  the  United  States  Public  Health  Service.  They 
tend  to  show  the  attitude  of  health  authorities  toward  (1) 
securing  milk  from  cattle  free  from  tuberculosis,  (2)  protection 
of  milk  against  contamination  from  human  sources,  and  (3) 
rendering  uncertified  milk  safe  for  human  consumption.  The 
essentials  of  the  various  State  laws  applying  to  the  protection 
of  milk  against  contamination  from  human  sources  are  as 
follows:  — 

California.  —  Requires  by  law  that  whenever  a  case  of  communicable 
disease  occurs  in  the  house  of  a  milkman,  milk  distributor  or  dealer 
no  milk  is  to  be  sold  or  distributed  by  him  until  the  health  authority 
designates  a  person  to  conduct  the  business  and  to  see  that  no  com- 
munication is  maintained  with  the  infected  house  except  under  official 
supervision. 

New  Jersey.  —  State  Board  of  Health  or  its  officers  required  to  prohibit 
transportation  of  milk  believed  to  have  been  contaminated  from  infected 
persons. 

Colorado,  Connecticut,  Illinois,  Maine,  Maryland,  Massachusetts,  Mich' 
igan,  Nebraska,  New  Jersey,  New  York,  North  Dakota.  —  Prohibit  sale  of 
impure  milk  or  milk  products  produced  under  unsanitary  conditions. 

Idaho,  Utah  and  Wyoming.  —  Forbid  by  regulation  the  sale  of  milk 
from  quarantined  premises. 

Pennsylvania.  —  State  Board  of  Health  requires  local  health  official  to 
notify  county  medical  inspector  when  milk  is  marketed  from  premises  in 
which  communicable  disease  prevails. 

Colorado,  Connecticut,  Illinois,  Maine,  Massachusetts,  Michigan,  Ne- 
braska, New  Jersey,  New  York,  North  Dakota.  —  Persons  in  charge  of  dairy 
farms  or  dairies  are  required  to  report  communicable  diseases  on  their 
farms  to  health  authorities. 

Ohio.  —  Requires  milk  from  infected  places  to  be  stopped. 


234 

California.  —  Requires  pasteurization  by  law  (act  of  May  4,  1915). 
No  person,  firm  or  corporation  shall  sell,  exchange  or  offer  or  expose  or 
have  in  its  possession  for  sale  or  exchange  any  milk,  cream,  skim  milk, 
ice  cream,  butter,  buttermilk,  cheese  or  other  milk  product  as  the  case 
may  be  nor  use  the  word  pasteurize  or  any  of  its  derivatives  in  connection 
with  the  sale,  etc.,  unless  the  same  and  all  products  of  milk  have  been 
treated  by  the  process  of  pasteurization. 

Durham  County,  N.  C,  has  a  regulation  with  special  refer- 
ence to  communicable  diseases  in  persons  engaged  in  the  pro- 
duction or  handling  of  milk,  which  reads  as  follows:  — 

No  person  having  tuberculosis,  any  venereal  disease,  or  any  other  com- 
municable disease  shall  work  in  any  milk  depot,  dairy,  or  in  any  other 
place  where  milk  or  its  products  are  handled.  When  typhoid  fever,  scarlet 
fever,  diphtheria,  small  pox,  measles,  or  chicken  pox  occur  in  a  house  or 
family  of  any  one  engaged  in  the  handling  of  milk  it  shall  be  the  duty  of 
the  owner  or  manager  to  notify  the  superintendent  of  health  at  once  of 
this  fact.  Examination  is  required  when  communicable  diseases  are  sus- 
pected. Any  dairyman  or  milk  dealer  authorized  under  this  ordinance 
or  any  employee  engaged  in  any  way  in  producing  and  handling  milk  or 
any  member  of  their  families,  or  any  persons,  residing  in  the  house  or  on 
the  premises  occupied  by  such  person,  if  suspected  of  having  any  com- 
municable disease,  may  be  required  to  submit  to  an  examination  at  the 
hands  of  the  superintendent  of  health.  .  .  .  Failure  to  co-operate  with 
the  superintendent  in  carrying  out  the  provisions  of  this  section  shall  be 
punished  by  the  revocation  of  the  permit  held  by  such  person,  firm,  or 
corporation. 

For  the  securing  of  milk  from  cattle  free  from  tuberculosis 
Richmond,  Va.,  and  Durham  County,  N.  C,  have  the  follow- 
ing regulations :  — 

Richmond,  Va.  —  Beginning  on  and  after  September  1,  1915,  no  person, 
firm  or  corporation  shall  sell  or  offer  for  sale  or  otherwise  dispose  of  within 
the  city  of  Richmond  or  shall  transport  or  carry  for  the  purpose  of  sale  in 
said  city,  or  shall  have  in  his  or  their  possession  with  intent  to  sell  or  offer 
for  sale  or  otherwise  dispose  of  in  said  city,  any  milk  or  cream  produced 
in  whole  or  in  part  from  cows  which  have  not  been  demonstrated  by  the 
tuberculin  test  to  be  free  from  tuberculosis,  said  test  to  have  been  made 
within  one  year.  Penalty  for  violation,  .  .  .  said  milk  or  cream  shall  be 
condemned  and  destroyed  by  the  food  inspector  or  one  of  his  assistants. 

Durham  County,  N.  C.  —  It  shall  be  unlawful  for  any  person,  firm  or 
corporation  authorized  under  the  provisions  of  this  ordinance  to  operate 
or  maintain  a  dairy  for  the  production  of  milk,  cream,  or  buttermilk  for 


235 

sale  or  other  distribution  in  the  city  of  Durham  or  sanitary  districts  of 
east  or  west  Durham,  to  use  the  milk  of  or  from  any  cow  that  has  not  been 
tuberculin  tested  by  the  meat  and  milk  inspector  or  other  officers  assigned 
to  make  such  tests. 

Spokane,  Wash.,  has  a  regulation  with  regard  to  pasteuriza- 
tion which  makes  it  unlawful  for  any  person  to  deliver,  sell  or 
have  or  offer  for  sale  or  delivery  in  the  city  of  Spokane,  any 
pasteurized  milk  unless  the  same  shall  have  plainly  marked  on 
each  bottle  a  label  bearing  the  inscription  "Pasteurized  Milk," 
and  unless  the  same  shall  have  been  pasteurized  within  twenty- 
four  hours  prior  to  delivery  to  the  consumer,  etc. 

The  following  are  sections  taken  from  the  1915  ordinance  of 
Seattle,  Wash.  They  are  models  that  might  well  be  followed 
by  other  communities. 

Section  16.  Provides  that  the  Commissioner  of  Health  shall  have  the 
right  and  is  hereby  empowered  to  condemn,  render  unsalable  and  return 
to  possessor  at  his  expense,  milk  to  which  any  foreign  substance  has  been 
added,  etc.  * 

Section  19.  Provides  that  the  Commissioner  of  Health  shall  have 
power  to  revoke  all  permits  to  receive  milk  within  the  city  of  Seattle  from 
dairies,  etc.,  outside  of  the  city  .  .  .  whenever  he  shall  deem  such  action 
necessary. 

Section  31.  Provides  that  it  shall  be  the  duty  of  the  Commissioner 
of  Health  as  often  as  he  shall  deem  necessary  to  inspect  all  dairies  .  .  . 
located  outside  the  limits  of  the  city  of  Seattle,  from  which  milk  is  shipped 
or  brought  into  the  city  of  Seattle. 

Section  34.  Provides  that  the  Commissioner  of  Health  shall  have  the 
right  and  is  hereby  empowered  to,  and  it  is  hereby  made  his  duty  to  ad- 
minister to  all  cows  within  the  city  of  Seattle,  an  accepted  test  for  the 
detection  of  tuberculosis,  as  often  as  he  shall  deem  necessary.  .  .  .  All 
animals  reacting  to  the  tuberculin  test  shall  be  marked  in  a  manner  satis- 
factory to  the  Commissioner  of  Health  for  purpose  of  identification.  .  .  . 
He  is  empowered  to  revoke  permit  issued  to  any  person  to  sell  milk  within 
the  limits  of  the  city  when  any  cow  reacts  to  accepted  test  .  .  .  and  is 
not  immediately  disposed  of  satisfactory  to  the  Commissioner  of  Health. 
Aforesaid  test  not  required  .  .  .  when  all  the  milk  produced  ...  is  pas- 
teurized ...  as  defined  in  another  section. 

Section  37.  Provides  that  it  shall  be  the  duty  of  all  persons  having 
charge  or  control  of  all  dairies,  etc.,  ...  to  notify  the  Commissioner  of 
Health  of  any  suspected  or  positive  case  of  typhoid  fever,  small  pox,  diph- 
theria, scarlet  fever,  tuberculosis,  septic  sore  throat  or  any  other  com- 
municable disease  in  any  person  upon  such  premises  and  no  person  suf- 


236 

fering  from,  or  those  coming  in  contact  with  such  persons,  etc.,  shall  work 
in  or  about  the  premises  where  milk  is  produced,  handled  or  offered  for 
sale,  for  consumption. 

Section  38.  Provides  that  all  persons  handling  milk  to  be  sold  in  the 
city  of  Seattle,  shall  be  subject  to  medical  examination  by  the  Commis- 
sioner of  Health,  free  of  charge.  ...  In  case  of  refusal  to  permit  said 
examination  .  .  .  permits  to  sell  milk  in  the  city  of  Seattle  shall  be  per- 
manently revoked. 

Section  44.  Provides  a  penalty  not  exceeding  one  hundred  (100)  dol- 
lars, or  imprisonment  in  the  city  jail  not  exceeding  thirty  (30)  days,  or 
both  for  violation  of  any  of  the  provisions  of  the  ordinance. 


APPENDICES. 


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Appendix    B 


FORMS  OF  QUESTIONNAIRE  AND  LETTERS  SENT  TO  LOCAL 
BOARDS  OF  HEALTH,  AND  A  LIST  OF  CITIES  AND 
TOWNS  FAILING  TO  REPLY  TO  QUESTIONNAIRE. 

Massachusetts  State  Department  of  Health, 
Boston,  July  21,  1915. 
To  the  Local  Board  of  Health. 

Gentlemen:  —  The  State  Department  of  Health  is  making  a  study 
of  the  relation  of  milk  to  the  transmission  of  disease. 

We  are  desirous  of  getting  as  complete  a  record  as  possible  of  all  cases 
of  typhoid  fever,  diphtheria,  scarlet  fever  and  septic  sore  throat,  where 
milk  has  been  proven  to  be  or  has  been  suspected  of  being  the  means  of 
transmission. 

We  will  appreciate  it,  therefore,  if  you  will  fill  out  the  enclosed  blank 
and  forward  it  to  us  at  your  earliest  convenience,  together  with  any 
other  facts  which  you  feel  may  have  a  bearing  on  this  important  matter. 
By  direction  of  the  Commissioner  of  Health, 

Sincerely  yours, 

Eugene  R.  Kellet, 
Director  of  Division  of  Communicable  Diseases. 


.1915. 


Dr.  Allan  J.  McLaughlin,  Commissioner  of  Health,  State  Department 
of  Health,  State  House,  Boston,  Mass. 
Dear  Sir  :  —  Below  you  will  find  a  list  of  the  cases  of  the  following 

diseases  occurring  in during  the 

years  1909-13,  classified  by  this  Department  with  reference  to  milk 
supply. 

n.„..«  Total  Number  of      Cases  due  to       Cases,  Milk 

diseases.  Caseg)  1909_13  Milk-  suspected. 

Typhoid  fever, 
Diphtheria, 
Scarlet  fever, 
Septic  sore  throat, 

r>TCTr«oir<=  Total  Number  of    Deaths  due  to    Deaths,  Milk 

diseases.  Deaths,  1909-13.  Milk.  suspected. 

Typhoid  fever, 
Diphtheria, 
Scarlet  fever, 
.  Septic  sore  throat, 

Yours  very  truly, 

Agent  or  Secretary  of  Board  of  Health. 


250 


Massachusetts  State  Department  of  Health, 
Boston,  Sept.  22,  1915. 
To  the  Local  Board  of  Health. 

Gentlemen:  —  Some  time  ago  this  Department  sent  to  all  local  boards 
of  health  in  the  Commonwealth  a  questionnaire  on  the  relation  of  milk 
to  certain  diseases.  In  looking  over  our  returns  we  do  not  find  your 
reply  among  them.    This  is  probably  an  oversight. 

We  need  this  information  to  complete  our  report  on  the  milk  question 
for  the  next  General  Court.  The  value  of  these  replies  will  be  directly 
proportional  to  number  of  towns  reporting.  The  subject  of  milk  in  its 
relation  to  disease  is  so  important  to  every  city  and  town  that  it  ought 
to  amply  repay  any  local  board  of  health  for  their  trouble  in  looking 
up  their  records  on  the  subject. 

As  you  know,  the  reports  of  infectious  diseases,  as  they  are  forwarded 
to  this  office,  do  not  indicate  the  known  or  suspected  source  of  the  in- 
fection. Consequently,  this  Department  can  only  gather  such  informa- 
tion as  is  asked  for  in  this  questionnaire  through  the  co-operation  of  the 
local  boards  of  health.  We  would,  therefore,  very  greatly  appreciate 
an  early  return  of  the  enclosed  questionnaire,  even  if  your  records  do 
not  show  any  cases  or  deaths  due  to  diseases  transmitted  by  milk. 

By  direction  of  the  Commissioner  of  Health, 

Sincerely  yours, 

Eugene  R.  Kelley, 
Director  of  Division  of  Communicable  Diseases. 


Cities  and  Towns  that  have  not  replied  to  Milk  Questionnaire 

Abington. 

Bridgewater. 

Falmouth. 

Acton. 

Brimfield. 

Florida. 

Adams. 

Buckland. 

Foxborough. 

Agawam. 

Burlington. 

Gardner. 

Amherst. 

Charlemont. 

Gay  Head. 

Arlington. 

Chelmsford  .- 

Georgetown. 

Ashfield. 

Chilmark. 

Gill. 

Barre. 

Clarksburg. 

Goshen. 

Bedford. 

Concord. 

Grafton. 

Belchertown. 

Conway. 

Granby. 

Bellingham. 

Dalton. 

Granville. 

Berkley. 

Dana. 

Groveland. 

Berlin. 

Dedham. 

Hadley. 

Bernardston. 

Dighton. 

Halifax. 

Billerica. 

Dudley. 

Hamilton. 

Blandford. 

East  Bridgewater. 

Hancock. 

Bolton. 

East  Longmeadow. 

Hardwick. 

Boxborough. 

Egremont. 

Harvard. 

Boylston. 

Enfield. 

Harwich. 

Brewster. 

Essex. 

Hawley. 

251 


Cities  and  Towns 

Heath. 

Hingham. 

Holbrook. 

Holliston. 

Hopkinton. 

Hudson. 

Hun. 

Huntington. 

Ipswich. 

Kingston. 

Lakeville. 

Lee. 

Leicester. 

Lenox. 

Leverett. 

Ley  den. 

Lincoln. 

Littleton. 

Longmeadow. 

Ludlow. 

Lynnfield. 

Manchester. 

Mansfield. 

Marblehead. 

MARI  BOROUGH. 

Marshfield. 

Mattapoisett. 

Maynard. 

Medfield. 

Medway. 

Middleborough. 

Middlefield. 

Middleton. 


that  have  not  replied  to  Milk 
Milford. 
Milton. 
Monson. 
Monterey. 
Nahant. 
Nantucket. 
Natick. 
Norfolk. 

North  Attleborough. 
Norton. 
Norwood. 
Oak  Bluffs. 
Orange. 
Otis. 

Pembroke. 
Peru. 
Plymouth. 
Plympton. 
Randolph. 
Rehoboth. 
Richmond. 
Rockland. 
Rowley. 
Royalston. 
Rutland. 
Salisbury. 
Savoy. 
Seekonk. 
Sheffield. 
Shelburne. 
Shrewsbury. 
Southampton. 
Southwick. 


Questionnaire  —  Concluded. 
Spencer. 
Sterling. 
Stoneham. 
Stoughton. 
Sturbridge. 
Sudbury. 
Sutton. 
Templeton. 
Tewksbury. 
Tisbury. 
Uxbridge. 
Wales. 
Wareham. 
Warren. 
Washington. 
Way  land. 
Wellfleet. 
Wendell. 

West  Bridgewater. 
West  Brookfield. 
West  Springfield. 
West  Stockbridge. 
Westborough. 
Westford. 
Weston. 
Weymouth. 
Whately. 
Whitman. 
Wilbraham. 
Wilhamsburg. 
Wrentham. 


252 


Appendix    C. 


ABSTRACT    OF    MILK-BORNE    EPIDEMICS    IN    MASSACHU- 
SETTS FROM   1906-15. 

The  following  is  an  abstract  of  epidemics  investigated  by  the 
State  Board  and  Department  of  Health  of  Massachusetts  from 
1907  to  1915,  in  which  milk  was  either  definitely  proven  to  have 
been  a  means  of  transmission  of  the  infection,  or  in  which  the 
epidemiological  evidence  of  milk  as  the  cause  was  considered 
strong  enough  to  classify  the  outbreak  as  among  the  milk-borne 
outbreaks. 


253 


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Recapitulation. 


Number  of 
Epidemics. 


Diphtheria, 
Scarlet  fever, 
Septic  sore  throat, 
Typhoid  fever,    . 


262 


Appendix 


COPY  OF  LETTER  SENT  TO,  AND  REPLIES  FROM,  EPIDEMI- 
OLOGICAL AUTHORITIES  OF  OTHER  STATES  RELATIVE 
TO  MILK  AND  DISEASE. 

The  following  is  a  copy  of  the  letter  sent  to,  and  replies  re- 
ceived from,  the  epidemiological  authorities  of  New  York,  New 
Jersey,  Pennsylvania,  Maryland,  Minnesota  and  Kansas:  — 

Boston,  Mass.,  July  30,  1915. 

Dear  Doctor:  —  This  Department  is  making  a  study  of  the  relation 
of  milk  to  communicable  diseases. 

We  are  especially  anxious  to  get  all  the  data  possible  on  cases  of  ty- 
phoid fever,  diphtheria,  scarlet  fever  and  septic  sore  throat  where  milk 
has  been  implicated  in  the  transmission  of  the  infection.  Are  your  routine 
epidemiological  reports  such  that  we  might  get  from  them  an  idea  of  the 
relative  frequency  of  milk  as  a  means  of  transmission  of  these  diseases  in 
your  State?  Would  it  be  asking  too  much  to  let  us  have  any  reports,  analy- 
ses or  studies  along  this  line  that  have  been  made  by  your  department? 

While  we  appreciate  the  extent  of  this  request,  we  are  impelled  to 
make  it  only  by  our  willingness  to  co-operate  with  you  in  a  like  manner 
at  any  time. 

By  direction  of  the  Commissioner  of  Health, 

Sincerely  yours, 

Eugene  R.  Kelley, 
Director  of  Division  of  Communicable  Diseases. 

Board  or  Health  of  the  State  of  New  Jersey,  Trenton,  Aug.  2,  1915. 

Eugene     R.    Kelley,    M.D.,    Director    of   Division    of   Communicable 
Diseases,  State  Department  of  Health,  Boston,  Mass. 
Dear  Doctor:  —  I  am  in  receipt  of  your  communication  of  July  30  in 
which  you  ask  for  information  in  regard  to  cases  of  typhoid  fever,  diph- 
theria, scarlet  fever  and  septic  sore  throat  traceable  to  milk  infection. 

We  have  no  special  articles  on  this  subject,  but  I  believe  there  is  on 
file  in  your  office  a  complete  set  of  the  annual  reports  of  tho  State  Board 
of  Health,  and  in  the  reports  of  the  last  five  or  six  years  you  will  find 
reports  of  interesting  epidemics  of  this  nature  which  have  occurred  in 
the  State  of  New  Jersey. 
With  kindest  regards,  I  am 

Very  truly  yours, 

A.   Clark  Hunt,  M.D., 

Chief. 


263 


Department  of  Health,  City  of  New  York, 
Bureau  of  Preventable  Diseases, 
139  Centre  Street,  New  York,  Dec.  31,  1915. 

Dr.  Eugene  R.  Kelley,  Director,  Division  of  Communicable  Diseases, 
Massachusetts  State  Department  of  Health,  Boston,  Mass. 

Dear  Doctor:  —  You,  of  course,  understand  the  impossibility  of 
judging  the  number  of  deaths  in  endemic  typhoid  due  to  milk,  for  the 
reason  that  no  one  can  designate  the  cases  as  they  appear.  All  that 
we  can  do  in  this  respect  is  to  weigh  one  set  of  milk  conditions  against 
another  and  ascribe  the  difference  to  one  of  them.  This  is  what  we  have 
done  in  comparing  the  number  of  cases  prior  to  pasteurization  of  milk 
with  the  number  after  the  pasteurization  of  milk.  As  the  fall  was  an 
abrupt  one  we  felt  that  we  were  right  in  our  conception  as  to  the  relative 
responsibility  of  raw  milk  for  the  endemic  disease,  especially  as  the  figures 
corresponded  so  closely  with  those  forecast  after  considering  the  ex- 
perience among  the  patrons  of  a  milk  company  selling  from  one  to  two 
hundred  thousand  quarts  a  day  of  pasteurized  milk  as  compared  with 
all  of  the  other  milk,  most  of  which  was  unpasteurized.  I  must  admit 
I  have  nothing  more  than  just  this,  and  at  the  same  time  I  can  account 
for  the  change  in  no  other  way. 

While  we  cannot  give  you  the  actual  number  of  cases  and  deaths  in 
the  so-called  residual  milk-borne  typhoid,  we  have  them  for  outbreaks 
and  submit  the  following :  — 

1912, 184  cases, 22  deaths. 

1913,  .    .    .    .'    .561  cases,    .    .    ...    .61  deaths. 

1914,  .....  No  outbreaks. 

1915,  .    .    .    .    .119  cases,    .    .    .    .    .15  deaths. 

This  brings  to  your  attention  an  outbreak  in  1915,  after  pasteuriza- 
tion was  generally  established.  This  was  a  very  interesting  occurrence. 
On  July  19,  1915,  3  cases  of  typhoid  fever  were  reported  from  one  com- 
paratively small  company,  one  doing  a  business  of  about  10,000  quarts 
in  a  limited  area,  supplying  about  one-tenth  of  the  population  therein. 
The  company  had  several  creameries,  but  all  3  cases  were  supplied  by 
one  creamery.  On  the  succeeding  day  3  other  cases  were  reported.  Tele- 
phone inquiry  developed  the  fact  that  various  creameries  had  contributed 
to  their  supply,  but  this  particular  creamery  had  participated  in  each 
instance.    The  milk  was  thereupon  excluded  from  the  city. 

A  careful  survey  of  the  conditions  at  the  creamery  town  showed 
several  cases  of  typhoid  fever  in  the  community,  and  an  examination  of 
the  well  water  used  in  washing  the  bottles  and  machinery  showed  a 
high  degree  of  contamination.  For  the  bottles  only  hot  water  or  steam 
was  used,  but  on  the  machinery,  especially  on  the  bottler  itself,  cold 
water  had  been  used  followed  by  hot  steam  for  sterilization.  Under 
the  conditions,  the  steam  penetrated  to  most  parts  of  the  machine,  but 
did  not  get  access  to  the  drop  or  funnel  arrangement  by  which  the  milk 
was  directly  conveyed  to  the  bottles.     As  a  certain  amount  of  milky 


264 

water  remained  in  this  situation  over  night  it  was  surmised  that  typhoid 
bacilli  may  have  been  present  and  developed  through  culture  over  night, 
resulting  in  a  high  degree  of  contamination  of  the  freshly  pasteurized 
milk.  The  well  was,  of  course,  at  once  sealed  up  before  the  milk  was 
allowed  to  re-enter,  and  there  has  been  no  further  trouble.  No  typhoid 
bacilli,  however,  were  found  in  the  water,  though  colon  bacilli  were  present 
in  a/ioo  cubic  centimeter,  as  obtained  directly  at  the  well.  This  goes 
to  show  the  danger  subsequent  to  pasteurization  under  the  present 
methods. 

Of  course,  pasteurization  in  bottles  would  obviate  all  of  this,  but'  the 
expense  of  the  glassware  and  the  manipulation  would  be  enormous. 

Very  truly  yours, 

M.  L.  Ogan, 
Chief,  Division  of  Epidemiology. 

New  York  State  Department  op  Health,  Albany,  Dec.  9,  1915. 

Dr.  Eugene  R.  Kelley,  Director,  Division  of  Communicable  Diseases, 
State  Department  of  Health,  Boston,  Mass. 
Dear  Dr.  Kelley:  —  Your  letter  of  November  27,  relative  to  the 
number  of  cases  of  communicable  disease  that  were  transmitted  by 
infected  milk  in  this  State,  is  received.  I  have  delayed  replying  because 
I  hoped  to  be  able  to  tabulate  the  reports  of  the  sanitary  supervisors 
on  this  subject,  but  I  find  that  many  of  them  reported  the  outbreaks 
with  a  question  mark  as  to  whether  or  not  milk  was  a  means  of  trans- 
mitting the  disease.  I  have,  therefore,  addressed  a  special  memorandum 
to  them  asking  them  to  review  their  work  during  the  past  year,  and  give 
me  a  statement  of  the  number  of  outbreaks  which  they  have  had  due 
to  infected  milk,  stating  the  number  of  cases  and  deaths  connected  with 
each  outbreak.  I  think  that  this  report  will  be  much  more  accurate 
than  one  which  I  could  tabulate  from  the  records. 

As  soon  as  this  report  is  received  I  shall  be  glad  to  forward  a  copy  to 
you. 

Very  truly  yours, 

F.  M.  Meader, 
Director,  Division  of  Communicable  Diseases. 

State  of  Maryland,  Department  of  Health, 

16  West  Saratoga  Street,  Baltimore,  Sept.  30,  1915. 

Dr.  Eugene  R.  Kelley,  Director,  Division  of  Communicable  Diseases, 
State  Department  of  Health,  Boston,  Mass. 
Dear  Doctor:  —  Several  weeks  ago  you  requested  data  on  milk- 
borne  outbreaks  of  typhoid  fever,  diphtheria,  scarlet  fever  and  septic 
sore  throat  in  Maryland.  A  prolonged  absence  from  the  city,  combined 
with  an  unusual  press  of  official  work,  prevented  my  sending  you  this 
information  at  an  earlier  time.     If  you  already  have  read  your  paper 


265 

on  the  subject,  I  trust  this  material  may  still  be  of  service  to  you  in  your 
printed  article. 

We  have  had  no  epidemic  of  diphtheria  or  of  scarlet  fever  in  which 
the  milk  supply  was  implicated,  but  we  have  had  7  outbreaks  of  typhoid 
fever  and  1  of  septic  sore  throat  attributed  to  milk.  I  shall'  next  give 
a  summary  of  the  typhoid  outbreaks,  arranged  in  chronological  order. 

Milk  Outbreaks,  Typhoid  Fever,  in  Maryland. 

1.  The  first  recorded  milk  epidemic  of  typhoid  fever  in  Maryland 
occurred  in  Elkton,  Cecil  County,  in  July,  August  and  September,  1884. 
There  were  20  cases,  but  no  death.  All  of  the  cases  but  one  were  supplied 
with  milk  from  a  certain  dairy  where  there  was  an  undoubted  case  of 
typhoid  fever.  The  outbreak  ended  when  the  use  of  this  dairyman's 
milk  was  discontinued. 

2.  Late  in  the  summer  and  early  in  the  autumn  of  1900  another  milk 
epidemic  of  typhoid  fever  occurred  in  Elkton,  Cecil  County.  This  out- 
break,1 traceable  to  a  single  dairy,  comprised  64  cases,  two  of  which  —  a 
white  woman  aged  fifty-six,  and  a  young  colored  woman  —  proved 
fatal.  The  outbreak  began  on  October  11  and  subsided  after  October  29. 
Within  the  first  eighteen  days,  during  which  time  the  dairyman's  business 
continued,  39  cases  of  typhoid  fever  occurred.  He  ceased  selling  milk 
on  October  28.  Within  three  weeks  following  that  date  20  additional 
cases  occurred.  Altogether  there  were  39  infected  houses.  The  dairy- 
man claimed  to  be  regularly  supplying  80  houses.  On  this  basis  the 
house  incidence  was  48.75  per  cent.  In  the  39  infected  houses  there 
were  180  people,  an  attack  rate  of  33^  per  cent.  The  case  rate  was  1.54 
per  house.  The  light  fatality,  3.3  per  cent.,  suggests  a  contagium  of 
slight  virulence.  The  incubation  period  was  variable,  ranging  from  nine 
to  eighteen  days.  The  first  21  cases  seemed  to  indicate  periods  of  in- 
cubation averaging  under  rather  than  over  fourteen  days.  Three  of  the 
patients  had  suffered  previous  attacks,  one  in  1884,  one  in  1893  and 
one  in  1898. 

3.  In  1903  an  outbreak  consisting  of  26'  cases  of  typhoid  fever,  4  of 
which  terminated  fatally,  developed  among  the  employees  of  a  shirt 
factory  located  in  Baltimore  City.  The  firm  operating  the  factory  served 
dairy  lunch,  the  milk  of  which  came  from  a  farm  where  the  water  supply 
was  polluted.    The  epidemic  ceased  when  the  milk  supply  was  changed. 

4.  In  May,  1904,  there  was  a  milk  outbreak  of  typhoid  fever,  con- 
sisting of  17  cases  with  1  death,  at  Port  Deposit,  Cecil  County.  The 
incubation  period,  as  is  usual  in  milk-borne  typhoid  fever,  was  short, 
all  of  the  cases  having  been  taken  ill  within  a  period  of  ten  days.  They 
had  a  common  milk  supply,  and  were  users  of  raw  milk.  Previous  to 
the  outbreak  there  had  been  a  case  of  illness  on  the  dairy  farm  which 
was  diagnosed  "grippe." 

1  See  an  interesting  and  comprehensive  report  of  this  outbreak  by  Dr.  Fulton,  in  the  Journal 
ofjHygiene,  London,  Vol.  I.,  1901,  pp.  422-429. 


266 

5.  In  October,  1905,  there  was  another  milk  outbreak  of  typhoid 
fever  in  Port  Deposit.  This  outbreak,  explosive  in  character  and  limited 
to  the  users  of  one  milk  supply,  comprised  19  cases,  1  of  which  proved 
fatal.  A  case  of  typhoid  was  found  on  the  farm  supplying  the  milk. 
The  outbreak  ceased  when  the  sale  of  this  milk  was  stopped. 

6.  In  April,  May  and  June,  1906,  there  was  a  remarkable  rise  in  the 
number  of  cases  of  typhoid  fever  in  the  Woodberry-Hampden  district 
of  Baltimore  City.  This  outbreak,  which  occurred  on  one  milk  route, 
led  to  the  discovery  that  one  of  the  farms  supplying  this  milk  had  cases 
of  the  disease  among  the  employees,  one  of  them  being  a  milker.  Stopping 
the  sale  of  this  milk  put  an  end  to  the  epidemic,  which  totaled  157  cases. 

7.  In  May  and  June  of  the  present  year  (1915)  there  was  an  outbreak 
of  typhoid  fever  at  the  Maryland  Tuberculosis  Sanatorium,  which  at- 
tacked the  several  groups  of  patients  and  employees  using  milk  from 
one  of  the  7  dairymen  supplying  the  institution.  Upon  investigation 
it  was  found  that  an  unrecognized  case  of  typhoid  fever  had  occurred 
in  April,  in  the  wife  of  the  dairyman  furnishing  the  infected  milk.  The 
outbreak  subsided  when  the  sale  of  milk  from  this  dairy  was  stopped. 
The  outbreak  consisted  of  27  cases,  19  of  them  tuberculous  patients 
and  8  healthy  persons.     Three  deaths  occurred  in  the  former  group, 

and  none  in  the  latter. 

i 

Septic  Sore  Throat. 
So  far  we  have  had  but  one  explosive  outbreak  of  septic  sore  throat 
in  Maryland,  spread  through  the  agency  of  milk.  This  occurred  in 
Baltimore  City  and  its  immediate  vicinity,  in  February  and  March, 
1912.  The  extent  of  this  epidemic,  apparently  a  streptococcus  infection, 
can  only  be  surmised.  It  may  be  estimated  that  certainly  not  less  than 
1,000  and  perhaps  as  many  as  3,000  cases  occurred,  causing  30  or  more 
deaths.  Over  85  per  cent,  of  the  cases  were  in  families  obtaining  their 
milk  supply  wholly  or  in  part  from  a  single  dairy. 

Very  truly  yours, 

C.  W.  G.  Rohrer, 
Acting  Chief,  Bureau  of  Communicable  Diseases. 

P.S.  —  Under  another  cover  I  am  sending  you  three  reprints  on  the 
septic  sore  throat  epidemic,  described  in  the  paragraph  immediately 
preceding.    Two  are  by  Dr.  Hamburger  and  the  third  by  Dr.  Frost. 

I  presume  you  already  possess  a  copy  of  Hygienic  Laboratorj'-  Bulletin 
No.  41,  entitled  "Milk  and  its  Relation  to  the  Public  Health,"  published 
in  1908.  It  is  replete  with  information  bearing  upon  the  relation  of 
milk  to  the  spread  of  communicable  diseases,  etc.  —  C.  W.  G.  R. 


267 

[Extract.] 

Nov.  27,  1915. 

Dr.  C.  Hampson  Jones,  Chief  of  Bureau  of  Communicable  Diseases,  De- 
partment of  Health,  Baltimore,  Md. 
Dear  Dr.  Jones:  — 

We  were  much  interested  in  receiving  a  communication  from  Dr. 
Rohrer,  giving  the  frequency  of  milk-borne  epidemics  of  typhoid  fever, 
scarlet  fever  and  diphtheria  according  to  his  records.  The  question  has 
come  up  as  to  whether  or  not  these  figures  include  Baltimore.  Will  you 
kindly  let  me  know? 

Sincerely  yours, 

Eugene  R.  Kelley, 
Director  of  Division  of  Communicable  Diseases. 

State  of  Maryland,  Department  of  Health, 

15  West  Saratoga  Street,  Baltimore,  Nov.  29,  1915. 

Dr.  Eugene  R.  Kelley,  Director,  Division  of  Communicable  Diseases, 
State  Department  of  Health,  Boston,  Mass. 

Dear  Doctor: — In  looking  over  Dr.  Rohrer's  letter  to  you  I  find 
that  his  report  includes  those  outbreaks  of  disease  that  occurred  not 
only  in  the  State,  but  in  Baltimore  City. 

I  found,  however,  that  one  similar  outbreak  in  Baltimore  City  has 
been  omitted  which  occurred  while  I  was  there,  and  a  report  of  it  was 
made  at  the  time  of  its  occurrence,  but  I  regret  to  say  that  I  cannot  now 
give  a  reference  to  the  same  nor  the  exact  date  of  outbreak.  It  is  my 
impression  that  it  was  somewhere  between  1908  and  1910,  and  that  it 
occurred  in  summer  time,  and  the  cases  were  detected  by  the  system 
we  had  in  the  Health  Department  of  daily  scanning  the  report  cards  of 
the  health  wardens  by  an  officer  of  the  Food  and  Dairy  Division,  the 
health  warden's  cards  showing  what  milk  was  consumed  by  the  family 
of  the  sick  one. 

A  dairy  located  in  the  tenth  ward  suddenly  looming  up  with  a  number 
of  cases  caused  a  review  to  be  made  of  the  producing  dairies  which  were 
sending  milk  to  it,  which  in  this  case  fortunately  happened  to  be  but 
few,  —  not  more  than  four,  —  so  we  quickly  examined  the  condition  of 
the  farms  of  each  producing  dairy  and  found  a  typhoid  fever  case  in  a 
Harford  County  dairy  that  was  sending  the  milk  to  the  distributing 
dairy  in  Baltimore  City.  The  closing  of  the  producing  dairy  until  all 
danger  had  passed  effectually  and  quickly  stopped  the  distribution  of 
the  disease.  My  recollection  is  that  there  developed  between  55  and 
60  cases  of  typhoid  fever  on  this  man's  milk  route. 

Yours  respectfully, 

C.  Hampson  Jones, 
Chief,  Bureau  of  Communicable  Diseases. 


268 


Minnesota  State  Board  of  Health, 

Division  of  Preventable  Diseases, 
University  Campus,  Minneapolis,  Minn.,  Aug.  3,  1915. 

Dr.  Eugene  R.  Kelley,  Director,  Division  of  Communicable  Diseases, 
Massachusetts  State  Board  of  Health,  Boston,  Mass. 
Dear  Dr.  Kelley:  —  We  will  be  glad  to  co-operate  with  you  in 
every  possible  way  in  your  study  of  the  relation  of  milk  to  typhoid, 
diphtheria,  scarlet  fever  and  septic  sore  throat. 

We  have  had  no  outbreak  of  septic  sore  throat  reported  in  Minnesota. 
We  have  a  considerable  number  of  records  showing  the  influence  of  milk 
in  the  spread  of  other  diseases.    I  will  collect  this  information  for  you 
as  soon  as  time  permits  and  forward  it. 
With  kindest  regards,  I  am, 

Respectfully, 

A.  J.  Chesley, 

Director. 

Minnesota  State  Board  of  Health, 

Division  of  Preventable  Diseases, 

Minneapolis,  Minn.,  Aug.  23,  1915. 

Dr.  Eugene  R.  Kelley,  Director,  Division  of  Communicable  Diseases, 
State  Board  of  Health,  State  House,  Boston,  Mass. 

Dear  Dr.  Kelley:  —  In  endeavoring  to  comply  with  your  request, 
regarding  instances  in  which  milk  has  been  implicated  in  the  transmission 
of  scarlet  fever,  diphtheria  and  typhoid  fever,  I  am  somewhat  disap- 
pointed. 

Dr.  Greene  was  kind  enough  to  go  through  the  records  of  the  Division 
very  carefully  from  Aug.  1,  1909,  to  date.  He  made  a  card  index  of 
reports  where  it  seemed  that  milk  might  have  been  a  factor  in  the  spread 
of  infection. 

I  have  gone  through  all  these  reports.  While  many  of  them  indicate 
that  milk  was  a  factor  to  some  extent  in  the  spread  of  disease,  only  in  a 
few  was  milk  the  chief  route  of  infection  or  definitely  proven  to  be  an 
active  factor.  As  you  know,  many  times  we  have  been  called  only  when 
the  epidemic  was  at  its  height,  sometimes  even  on  the  wane,  and  the 
data  which  are  collected  under  such  conditions  are  not  conclusive,  al- 
though they  are  very  suggestive. 

Certain  of  the  instances  are  given  in  the  enclosed  summaries.  Others 
are  to  be  found  in  the  published  reports. 

To  begin  with,  I  may  mention  one  due  to  butter,  not  milk.  '  The  sum- 
maries for  this  will  be  found  under  the  heading,  Anoka  Tj-phoid,  May 
29  to  30  and  June  5  to  6,  1912,  page  240,  Report  of  the  Division  of  Epi- 
demiology, August,  1910,  to  August,  1912. 

Some  explanation  is  necessary  in  addition  to  the  information  given 
in  the  Summaries.    Dr.  Hill  made  a  very  careful  epidemiological  study, 


269 

but  was  obliged  to  leave  Anoka  before  he  had  finished,  and  sent  me  to 
finish  the  work.  He  left  his  epidemiological  notes  (mostly  illegible), 
and  told  me  how  he  had  sized  up  the  situation.  Acting  upon  his  theory 
of  causation,  I  used  such  data  as  I  could  unravel  from  his  notes,  then 
attempted  to  solve  the  problem  upon  a  certain  hypothesis.  I  never  did 
such  a  thing  before,  and  have  never  attempted  it  since.  Of  course  the 
hypothetical  solution  was  to  be  checked  up  by  actual  investigation. 

Assuming  that  butter  was  responsible  for  the  spread  of  typhoid  in- 
fection, Dr.  Hill  had  record  of  the  number  of  persons  in  each  family  who 
used  the  suspected  butter.  A  grocer  simply  acted  as  a  distributor  to 
regular  customers.  The  packages  were  never  opened  between  the  dairy 
and  the  customer.  There  was  record  of  every  package  delivered.  Dr. 
Hill  had  noted  whether  the  families  had  butter  left  from  previous  de- 
liveries or  not. 

I  weighed  a  piece  of  butter  about  the  size  of  a  chunk  ordinarily  con- 
sumed by  one  individual  at  a  meal,  and  figured  how  many  pieces  of  this 
size  there  would  be  in  each  jar  delivered.  On  figuring  out  the  time  the 
butter  would  last,  it  appeared  that  it  had  all  been  consumed  four  days 
before  Dr.  Hill  was  notified  that  the  epidemic  was  in  progress,  and  there- 
fore all  the  precautions  taken  were  of  no  avail.  It  appeared  that  other 
cases  would  come  down,  up  to  a  certain  time. 

For  instance,  in  packing  the  butter  into  the  jars,  the  upper  part  of 
the  first  crock  would  be  contiguous  to  the  bottom  of  the  second  jar;  and 
if  we  assume  that  infection  from  the  fingers  occurred  at  this  time,  then 
the  family  using  butter  from  the  first  jar  should  fall  ill  earlier  than  the 
family  using  butter  from  the  second  jar,  because  they  would  not  get 
any  infected  material  until  the  bottom  of  the  jar  was  reached.  In  other 
families  who  had  some  butter  from  previous  deliveries  on  hand,  the 
infection  would  not  be  incurred  at  the  time  it  would  in  the  first  family 
mentioned. 

The  only  persons  who  had  typhoid  who  were  not  in  the  families  of 
regular  customers  for  this  butter  attended  a  church  social  where  a  woman 
who  supplied  butter  had  the  jar  from  the  dairy  delivered  at  the  time  it 
was  assumed  the  batch  had  been  infected.  It  was  one  of  those  socials 
where  certain  items  are  supplied  by  certain  women,  and  this  \a.dy  supplied 
the  infected  butter,  it  seems. 

I  went  directly  to  the  farm  and  found,  upon  questioning  the  people, 
that  a  girl  visiting  in  the  family  had  packed  the  particular  batch  of 
butter  under  suspicion.  The  farmer's  wife  made  the  butter,  as  usual, 
but  on  the  morning  it  should  have  been  delivered  she  was  sick  and  asked 
the  girl  to  pack  the  butter  into  the  jars.  This  girl  had  been  feeling  unwell 
for  some  time,  and  had  consulted  a  woman  physician,  who  afterwards 
admitted  that  the  girl  undoubtedly  had  walking  typhoid,  although  she 
did  not  report  the  case  to  the  local  health  officer  or  send  blood  for  Widal 
test.  The  s37mptorns  the  girl  gave  were  suspicious.  A  blood  test  showed 
Widal  reaction  present.    Attempts  were  made  to  isolate  typhoid  bacilli 


270 

from  her  discharges,  and  finally  an  organism  was  obtained  which  was 
typical  for  typhoid,  except  in  one  of  the  sugar  media.  It  agglutinated 
with  her  blood. 

We  did  not  tell  the  grocer  or  the  customers  that  we  had  found  the 
epidemic  to  be  due  to  the  use  of  infected  butter.  The  farmer's  wife  had 
already  made  two  or  three  batches  of  butter,  and  it  had  been  used,  and 
we  let  them  go  on  just  as  usual.  The  butter  found  to  be  infected  was 
the  only  batch  which  had  been  packed  by  any  one  except  the  farmer's 
wife. 

There  is  another  instance  given  where  cheese,  as  well  as  milk,  had 
something  to  do  with  the  spread  of  typhoid  infection.  (See  Summaries 
271  and  279,  XIV.;  also  the  extract  from  the  health  officer's  report 
written  on  the  back  of  the  Confidential  Data  for  279.) 

We  had  a  lot  of  trouble  about  this  case,  for  the  people  sold  their  farm 
and  moved  into  town,  and  later  threatened  to  sue  the  health  officer  and 
the  State  Board  of  Health  for  ruining  their  business. 

In  Summaries  60  and  73,  XIII.,  there  is  another  instance  of  typhoid 
being  spread  by  milk. 

Summary  132,  XIII.,  is  given  to  supplement  the  report  on  page  73 
of  the  Division  of  Epidemiology  report,  Aug.  1,  1912,  to  Dec.  31,  1913. 
While  we  •  did  not  personally  collect  the  epidemiological  data  for  the 
St.  Paul  cases,  we  checked  over  every  point  with  the  St.  Paul  Health 
Department,  and  I  am  sure  that  this  showed  a  clear-cut  milk-borne 
infection,  although  we  did  not  prove  by  laboratory  tests  that  the  sus- 
pected carrier  had  typhoid  bacilli  in  his  discharges. 

In  Summary  169,  XIV.,  the  solution  is  given  for  cases  of  typhoid  in 
Stillwater  which  had  not  been  traced  previously.  I  made  an  investiga- 
tion there  in  1912,  and  was  unable  to  find  the  source  of  infection.  It  is 
true  that  there  were  but  few  cases,  and  they  were  scattered  over  a  con- 
siderable period  of  time,  making  it  impossible  to  get  reliable  information 
as  to  milk,  etc.,  common  to  the  different  cases.  Dr.  Greene  worked  it 
out  in  1914,  and  later  Dr.  F.  L.  Landeen  gave  us  further  information, 
as  follows :  — 

"I  have  a  list  of  16  typhoid  cases,  half  of  which  I  attended  profession- 
ally. Twice,  at  least,  cases  have  come  in  waves,  those  occurring  eight 
years  ago  and  this  year  (1914).  Some  cases  were  light,  some  ordinary 
and  some  fatal.  I  have  no  way  of  getting  records  further  back  than 
seventeen  years  ago,  when  the  first  case  in  my  list  occurred." 

Dr.  Landeen  stated  that  all  of  these  cases  were  traceable  to  the  carrier 
discovered  by  Dr.  Greene.  This  woman  had  supplied  milk  to  neighbors 
for  many  years. 

The  final  milk-borne  typhoid  report  is  that  for  the  School  for  Feeble 
Minded  at  Faribault.  You  will  find  that  Summaries  88  and  95,  XIV., 
will  give  you  a  better  idea  of  the  conditions  at  the  school  than  if  you 
had  only  the  three  which  relate  specifically  to  the  milk-borne  infection, 
namely,  187,  197  and  232,  XIV.     There  was  further  comment  in  the 


271 


State  of  Kansas, 
Department  of  the  State  Board  of  Health, 

Topeka,  Kan.,  Aug.  6,  1915. 

Dr.  E.  R.  Kelley,  Director,  Division  of  Communicable  Diseases,  Boston, 

Mass. 
Dear  Doctor  :  —  Replying  to  yours  of  July  29,  will  say  that  it  has 
been  impossible  for  this  department  to  publish  in  a  routine  way  all  the 
epidemiological  investigations.  As  you  know,  our  bulletin  is  always 
crowded,  and  the  State  printer  does  not  see  fit  to  loosen  up  with  any 
more  paper. 

However,  replying  to  your  inquiry  directly,  will  say  that  we  have 
had  only  two  epidemics  traceable  directly  to  milk  in  the  past  two  years. 
One  was  the  epidemic  of  typhoid  at  Parsons  and  another  at  Wichita. 
The  Wichita  report  has  not  been  published,  but  we  are  sending  you  here- 
with the  Parsons  report.  The  department  has  knowledge  of  other  epi- 
demics which  have  been  attributed  to  milk,  but  there  are  no  definite 
epidemiological  records.  We  shall  be  very  glad,  however,  to  send  you 
future  reports  along  this  line  from  time  to  time. 
With  kindest  regards,  I  am, 

Fraternally  yours, 

John  J.  Sippy,  M.D., 
Epidemiologist. 


272 

paper  by  Miss  Wade  and  Dr.  McDaniel  on  this  epidemic.  See  enclosed 
reprint,  "Observations  on  the  Widal  Reaction  following  the  Administra- 
tion of  Typhoid  Vaccine." 

The  Faribault  school  is  Institution  B.  It  is  a  curious  thing  that  the 
only  cases  of  typhoid  that  have  appeared  in  this  school  since  the  epidemic 
reported  have  been  among  persons  who  did  not  show  Widal  reaction 
present,  although  they  were  said  to  have  been  properly  vaccinated. 

There  is  another  reference  to  this  epidemic  in  an  article  by  Dr.  Mc- 
Daniel and  Miss  Wade  in  the  August  "Journal  of  the  American  Public 
Health  Association."  I  will  send  you  later  a  reprint  of  an  article  by 
Dr.  Hill,  relating  to  the  spread  of  typhoid  through  milk  in  North  Branch, 
Minn.  This  occurred  several  years  ago,  when  I  was  bacteriologist,  and 
I  had  to  send  away  to  get  reprints,  but  will  have  them  for  you  soon. 

In  regard  to  milk  in  diphtheria,  see  page  313  of  the  Laboratory  Di- 
vision Report,  1911  to  1913.  In  addition,  for  a  butter-borne  diphtheria 
infection,  see  page  203  of  the  Division  of  Epidemiology  report,  Aug.  1, 
1910,  to  Aug.  1,  1912. 

In  regard  to  the  length  of  time  that  diphtheria  bacilli  survive  in  butter, 
Dr.  L.  P.  Pearsall  conducted  experiments  several  years  ago  which  showed 
that  virulent  diphtheria  bacilli  could  be  recovered  from  butter  kept 
under  various  conditions  for  two  to  three  months.  Some  of  the  butter 
from  which  the  bacilli  were  recovered  was  so  long  kept  that  it  was  unfit 
for  human  consumption. 

Regarding  milk  in  scarlet  fever,  we  have  records  of  three  epidemics 
where  it  is  probable  that  milk  played  a  part  in  the  spread  of  scarlet  fever. 
However,  I  have  not  given  these,  since  the  evidence  was  not  conclusive. 
The  epidemic  outlined  in  Summary  76,  XIV.,  was  very  clear  cut.  It 
was  milk  borne  without  question. 

In  regard  to  septic  sore  throat,  no  epidemic  has  occurred,  to  our  knowl- 
edge, in  Minnesota.  I  may  say  that  in  several  epidemics  which  I  person- 
ally investigated  there  was  strong  circumstantial  evidence  indicating 
that  milk  was  the  main  route  of  infection.  However,  careful  investiga- 
tion proved  that  appearances  were  deceptive,  for  it  was  readily  shown 
that  the  milk  could  not  have  been  infected,  and  the  cases  suspected  to 
be  milk  infections  were  traced  to  direct  contact  with  known  cases  at  a 
time  which  would  account  for  the  infection. 

I  am  sorry  that  we  have  no  more  definite  material  for  you,  but  I  have 
asked  Dr.  I.  J.  Murphy,  now  executive  secretary  of  the  Minnesota  Public 
Health  Association,  but  for  many  years  epidemiologist  for  the  Duluth 
city  Board  of  Health,  to  look  up  certain  milk-borne  infections  which  he 
investigated  in  Duluth.  He  promised  to  do  this.  When  I  receive  his 
notes  I  will  forward  the  information. 

A.  J.  Chesley, 

Director. 


273 


Appendix    E 


INFLUENCE  OF  PASTEURIZATION  ON  CHEMICAL  CONTENT 

OF  MILK. 


BY  HERMANN  C.  LYTHGOE,  CHARLES  H.  HICKEY  AND  CLARENCE  E.  MARSH. 


This  work  was  undertaken  by  reason  of  the  testimony  of 
certain  commercial  chemists  in  a  contested  case,  to  the  effect 
that  the  pasteurization  of  milk  would  tend  to  lower  the  refractive 
index  of  the  milk  serum  by  causing  a  hydrolysis  of  the  milk 
sugar  and  thereby  reaucing  the  concentration  of  the  serum  to 
such  an  extent  that  a  sample  of  normal  market  milk  free  from 
added  water  would  be  almost  certain  to  be  considered  adulterated 
when  tested  by  means  of  the  usual  methods  devised  for  that 
purpose.  These  chemists  never  published  this  statement, 
probably  owing  to  the  fact  that  careful  experiments  would  show 
its  absolute  fallacy. 

After  the  work  was  completed  it  was  found  that  in  addition  to 
solving  the  problem  investigated  we  had  obtained  valuable  data 
for  other  considerations. 

In  order  to  show  whether  or  not  the  influence  of  heat  upon 
lactose  solutions  caused  a  reduction  in  its  refractive  index,  an 
aqueous  solution  of  lactose  was  divided  into  two  parts,  to  one  of 
which  some  citric  acid  was  added.  Each  of  these  solutions  was 
divided  into  three  parts,  one  of  which  was  connected  with  a 
return-flow  condenser  and  heated  in  a  boiling  water  bath  for  ten 
minutes.  Another  was  heated  in  a  similar  manner  for  forty-five 
minutes,  and  the  third  portion  was  kept  at  the  room  tempera- 
ture. It  would  appear  that  if  any  great  change  in  concentration 
due  to  hydrolysis  occurred  by  heating  lactose  solutions  it  would 
be  shown  by  these  experiments.  The  results  are  shown  in 
Table  I. 


274 


Table  I.  —  Influence  of  Heat  on  Lactose  Solutions. 


Temperature 
(Degrees  C). 


Refractive 
Index. 


Polarization 

200  millimeters, 

Ventake  Scale. 


Lactose  solution:  — ■ 

Not  heated 

Heated  ten  minutes, 
Heated  forty-five  minutes, 

Lactose  citric  acid  solution:  — ■ 
Not  heated,       .... 
Heated  ten  minutes, 
Heated  forty-five  minutes, 


22.5 
22.5 
22.5 

22.5 
22.5 
22.5 


43.6 

43.8 
43.8 

46.3 
46.4 
46.6 


25.16 
24.50 
24.30 

24.56 
24.50 
24.54 


These  figures  show  that  the  boiling  of  lactose  solutions  with 
or  without  the  addition  of  citric  acid  has  practically  no  influence 
upon  the  refractive  index. 

In  order  to  determine  the  effect  of  pasteurization  upon  milk 
and  cream,  20  samples  of  milk  of  known  purity  and  2  samples  of 
certified  milk  were  obtained.  In  collecting  the  samples  of  known 
purity  milk,  the  dairies  in  each  instance  were  visited  by  one  or 
more  of  us,  the  cows  milked  in  our  presence,  and  a  6-quart 
sample  of  the  thoroughly  mixed  milk  taken  from  the  mixing 
tank.  In  two  instances,  owing  to  the  fact  that  the  mixing  tank 
was  small  and  bottling  was  begun  before  all  the  cows  were 
milked,  6  1-quart  samples  were  taken  intermittently  during  the 
bottling  in  such  a  manner  that  the  mixture  of  these  samples  gave 
a  fairly  accurate  indication  of  the  herd  milk.  The  samples  were 
all  milked  in  the  evening.  The  next  day  the  sample  was 
thoroughly  mixed  and  two  one-half  pint  portions  removed;  the 
balance,  after,  warming  to  blood  heat,  was  passed  through  the 
separator.  The  cream  was  divided  into  parts  and  two  one-half 
pint  samples  of  the  skimmed  milk  were  taken.  One  sample  each 
of  the  whole  milk,  skimmed  milk  and  cream  were  then  pasteur- 
ized by  placing  the  bottles  in  warm  water,  stirring  with  a 
thermometer  until  the  desired  temperature  was  attained.  The 
bottles  were  then  stoppered  and  placed  in  a  thermostat  heated  to 
the  temperature  of  pasteurization,  where  they  were  kept  for 
thirty  minutes  or  more.  In  some .  instances  samples  were  with- 
drawn during  the  holding  process.  After  the  holding  period  had 
elapsed  the  samples  were  cooled.     In  four  instances  the  whole 


275 

milk  was  not  pasteurized.  The  raw  and  pasteurized  samples 
were  then  submitted  to  analysis,  determinations  being  made  in 
most  instances  of  solids,  fat,  total  proteins,  ash,  lactose,  copper 
serum  refraction,  sour  serum  refraction  and  sour  serum  ash. 
After  the  refractive  index  had  been  determined  the  serum  was 
placed  in  a  test  tube,  heated  in  boiling  water  for  five  minutes, 
cooled,  filtered  and  the  refractive  index  of  the  clear  filtrate  de- 
termined. Owing  to  the  limited  quantity  of  sample,  particularly 
of  cream,  the  work  could  not  be  done  in  duplicate;  therefore  the 
majority  of  the  figures  reported  are  the  result  of  single  determi- 
nations. Sample  X  was  treated  in  a  somewhat  different  manner. 
A  one-half  pint  ^sample  of  the  whole  milk  was  removed,  and 
2\  quarts  were  passed  through  the  separator  in  order  to  obtain 
the  raw  milk,  skimmed  milk  and  cream.  The  remaining  3 
quarts  were  pasteurized,  and  while  still  hot  2\  quarts  were 
passed  through  the  separator  in  order  to  obtain  the  samples  of 
pasteurized  milk,  skimmed  milk  and  cream.  The  resulting 
cream,  therefore,  contained  a  different  fat  content  than  that 
obtained  from  the  raw  milk,  and  no  attempt  was  made  to  adjust 
the  raw  cream  by  adding  skimmed  milk.  The  results  of  the 
analyses  are  given  in  Table  II. 


276 


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It  will  be  seen  from  a  perusal  of  these  tables  that  heating  has 
but  little  effect  upon  the  percentage  of  the  milk  constituents 
estimated  other  than  that  caused  by  a  slight  concentration.  In 
the  case  of  the  serum,  however,  there  was  a  diminution  of  the 
refractive  index  due  to  more  or  less  coagulation  of  the  albumin. 
The  maximum  and  average  differences  between  the  milk  con- 
stituents are  shown  in  the  following  table. 


Table  III.  —  Difference  between  Raw  and  Pasteurized  Samples. 

Milk. 


Maximum  Difference. 

Average 
pasteurized. 

Pasteurized 
above  — 

Pasteurized 
below  — 

Solids, 

0.48 

0.06 

0.17    higher 

Fat 

0.20 

0.10 

0.04    higher 

Proteins, 

0.05 

0.15 

0.01    lower 

Ash, 

0.08 

0.09 

0.003  lower 

Lactose, 

0.70 

0.10 

0.005  higher 

Skimmed  Milk. 


Solids, 
Fat,  . 
Proteins, 
Ash. 
Lactose, 


0.095  higher 

0.003  higher 
0.008  lower 
0.036  higher 


Cream. 


Fat,  . 
Proteins, 
Ash, 
Lactose, 


0.045  lower 
0.022  higher 
0.022  higher 
0.018  higher 


Comparison  of  Serum  of  Milk,  Skimmed  Milk  and  Cream. 

The  serum  of  skimmed  milk  and  of  cream  is  the  same  as  that 
of  the  whole  milk  from  which  it  was  obtained,  although  our 
figures  in  a  few  instances  do  not  seem  to  bear  out  this  statement. 
The  variations  in  the  refractive  index  of  the  sour  serum  are  due, 
no  doubt,  to  changes  in  the  character  and  the  duration  of  the 


281 

fermentation.  If  the  same  sample  of  milk  is  divided  into  several 
portions  and  fermented  with  different  ferments,  the  refractive 
indices  of  the  serums  will  be  different.  The  variation  in  the 
refractive  indices  of  the  copper  serums  made  from  milk,  skimmed 
milk  and  cream  from  the  same  source  can  be  explained,  as 
follows:  It  is  a  well-known  fact  that  if  a  sample  of  milk  is 
allowed  to  set,  the  bacterial  content  of  the  cream  is  greater  than 
that  of  the  skimmed  milk.  These  samples  in  which  the  serum 
refraction  of  the  cream  was  greater  than  that  of  the  milk  were 
obtained  under  such  circumstances  that  they  could  not  be  cooled 
at  the  time  of  milking,  and  were  not  transferred  to  the  laboratory 
ice  chest  for  some  hours.  The  following  morning  it  was  noticed 
that  the  cream  was  slightly  sour,  although  the  balance  of  the 
milk  was  normal.  The  samples  undoubtedly  were  not  poured 
over  sufficiently  to  make  the  serum  uniform  throughout  the 
entire  mass,  although  the  fat  was  evenly  distributed.  As  the 
refractive  index  of  the  copper  serum  of  milk  is  higher  if  the 
serum  is  prepared  after  the  sample  is  sour,  the  apparent  dis- 
crepancy is  thus  accounted  for. 

Influence  of  Pasteurization  on  Milk  Serum. 

The  heating  of  milk  has  a  tendency  to  produce  a  diminution 
of  the  refractive  index  of  those  milk  serums  which  contain  the 
coagulable  albumin.  The  higher  the  temperature  the  greater 
will  be  the  influence  until  complete  coagulation  takes  place  at 
about  85°  C.  or  185°  F.  The  coagulation  begins  at  64°  C.  or 
147°  F.,  below  which  apparently  it  cannot  take  place  in  sufficient 
quantity  to  affect  the  serum.  The  refractive  index  of  the  copper 
and  sour  serums,  the  ash  of  sour  serums  and  the  temperature  of 
pasteurization  of  the  samples  are  given  in  Table  IV. 


282 


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The  diminution  of  the  refractive  index  of  the  serum  by 
pasteurization  is  influenced  by  the  per  cent,  of  fat  in  the  sample 
as  well  as  by  the  temperature  to  which  it  has  been  heated. 
Milk  with  a  high  fat  content  has  a  high  protein  content,  and  milk 
with  a  low  fat  content  has  a  low  protein  content.  A  sample  of 
milk  containing  5  per  cent,  fat  would  contain  about  0.7  per  cent, 
coagulable  albumin.  A  sample  with  4  per  cent,  fat  would  con- 
tain about  0.6  per  cent,  albumin  and  one  with  3  per  cent,  fat, 
about  0.5  per  cent,  albumin.  The  complete  coagulation  of  the 
albumin  in  a  sample  of  milk  from  a  herd  of  Jersey  cows  would 
have  more  influence  in  lowering  the  refractive  index  of  the  serum 
than  if  the  sample  was  obtained  from  a  herd  of  Holstein  cows. 
As  the  milk  with  a  high  fat  content  gives  a  more  concentrated 
serum  than  the  milk  with  a  low  fat  content,  the  influence  of 
heating  is  less  marked  in  the  latter  case;  in  fact,  the  copper 
serum  and  sour  serum  prepared  from  boiled  milk  is  more  uniform 
than  that  prepared  from  raw  milk.  The  refractive  index  of  the 
average  milk  would  be  reduced  to  an  extent  of  1.8  scale  divisions 
by  boiling;  therefore  with  a  sample  of  milk  containing  5  per  cent, 
fat  we  should  expect  a  reduction  of  about  2.1  scale  divisions,  and 
with  a  sample  containing  3  per  cent,  fat,  a  reduction  of  1.3  scale 
divisions.  The  influence  of  both  heat  and  fat  content  upon  the 
diminution  of  the  refractive  index  of  the  copper  serum  is  shown 
in  Table  V.,  the  figures  being  obtained  from  Table  IV. 

Table  V. 


Number  of  Analyses. 


5, 
11, 
6, 

3, 
14, 

11, 

9, 

12, 
3, 

11, 

20, 


Temperature. 


Degrees  C. 


SO 


Degrees  F. 


176 
176 
176 

167 
167 
167 

165 
165 
165 

158 
158 
158 


Average  fat. 


4.05 
3.82 
3.60 

4.70 
3.94 
3.50 

3.95 
3.74 
3.20 

4.05 
3.95 
3.48 


Average  Difference 

between  Re- 
fraction of  Copper 

Serum  before 
and  after  Heating. 


1.70 
1.40 
1.20 

1.11 
1.11 
1.10 

0.90 
0.85 
0.80 

0.73 
0.63 
0.54 


287 


From  the  figures  in  Table  IV.  the  relation  between  the  temper- 
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should  be  understood  that  these  figures  are  somewhat  influenced 
by  the  duration  of  time  the  milk  has  been  kept  at  the  tempera- 
ture specified. 

Table  VI. 


Temperature. 

Per  Cent,  of 

Albumin 
coagulated. 

Temperature. 

Per  Cent,  of 

Albumin 
coagulated. 

Degrees  C.         Degrees  F. 

Degrees  C. 

Degrees  F. 

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140 

- 

75 

167 

60 

65 

149 

10 

77 

171 

70 

67 

153 

20 

78 

172 

80 

69 

156 

30 

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289 

The  figures  obtained  from  those  samples  which  were  removed 
during  the  heating  and  holding  process  in  order  to  obtain  the 
relative  rate  of  reduction  of  the  refractive  index  of  the  serum 
are  given  in  tabular  form  in  Table  VII. 

Judging  from  the  results  obtained  from  known  purity  milk 
heated  slowly  in  bulk  in  the  laboratory,  we  have  arrived  at  the 
conclusion  that  practically  no  chemical  effect  takes  place  in  milk 
upon  heating  until  the  temperature  of  64°  C.  or  147°  F.  has  been 
attained.  As  the  temperature  increases  above  this  point  the 
albumin  gradually  becomes  insoluble,  and  the  refractive  index  of 
the  serum  decreases  until  the  temperature  reaches  85°  C.  or 
185°  F.,  above  which  (up  to  the  boiling  point)  no  further  in- 
fluence is  apparent.  The  influence  of  holding  is  not  so  marked 
as  that  of  heating,  and  the  reduction  of  the  refractive  index  of 
the  serum  is  less  a  factor  of  the  length  of  time  than  of  the 
temperature,  for  if  the  latter  is  below  64°  C.  or  147°  F.  the  time 
of  holding  is  without  influence  upon  the  coagulability  of  the 
albumin. 

Pasteurization  is  without  influence  upon  the  sour  serum  ash, 
notwithstanding  the  fact  that  the  heating  of  milk  above  72°  C. 
or  161°  F.  causes  the  precipitation  of  some  of  the  calcium  salts, 
the  exact  nature  of  which  is  at  present  a  matter  of  controversy, 
but  which  is  coincident  with  the  destruction  of  the  peroxidases. 
The  formation  of  lactic  acid  during  the  souring  of  the  milk 
causes  a  complete  solution  of  any  precipitated  mineral  matter, 
and  consequently  the  sour  serum  ash  of  pasteurized  milk  is  the 
same  as  that  obtained  from  the  raw  milk. 

The  term  pasteurization  as  used  herein  has  been  somewhat  of 
a  misnomer  as  it  has  been  applied  where  the  terms  cooked, 
boiled  or  scalded  should  have  been  used.  Commercial  pasteuriza- 
tion is  carried  out  at  a  temperature  of  62.8°  C.  or  145°  F.,  the 
milk  going  to  holding  chambers  where  it  is  kept  for  from  thirty 
minutes  to  one  hour.  Under  these  circumstances  there  is  prac- 
tically no  coagulation  of  the  albumin,  and  therefore  there  is  no 
liability  of  commercial  milk  giving  a  serum  of  lower  concentra- 
tion than  would  be  obtained  from  the  same  milk  before  heating. 
If,  however,  milk  has  been  heated  sufficiently  to  cause  any 
marked  diminution  of  the  albumin,  it  may  be  detected  by  per- 
forming the  peroxidase  reaction  which  will  be  negative,  in  which 
instance  a  lower  figure  may  be  selected  for  the  minimum  re- 
fractive index. 

After  the  above  experiments  had  been  performed  and  the 
results  compiled,  it  was  decided  to  investigate  the  influence  of 


290 

commercial  pasteurization  upon  milk.  Three  pasteurization 
plants  near  Boston  were  visited,  and  samples  were  taken  before 
and  after  pasteurization.  One  plant  used  the  flash  system,  heat- 
ing momentarily  to  74.4°  C.  or  16.6°  F.,  and  cooling  immediately, 
the  entire  process  from  the  mixing  tank  to  the  bottles  taking 
about  one-half  minute.  In  this  plant  two  samples  were  taken 
before  and  two  after  pasteurization  at  such  an  interval  of  time 
that  the  pasteurized  samples  represented  substantially  the  same 
milk  as  the  corresponding  raw  samples.  The  other  plants  from 
which  samples  were  taken  used  the  holding  system,  the  milk 
being  instantaneously  heated  to  146-147°  F.  (63.3°-63.9°  C), 
transferred  to  holding  chambers  with  a  loss  of  3  to  4°  F.,  held 
for  a  period  of  thirty  minutes  with  a  loss  of  1  to  2°  F.,  cooled 
and  bottled.  Two  samples  were  taken,  one  each  from  the  mixing 
tank,  from  the  outlet  of  the  cooler  and  the  outlet  of  the  holder 
at  such  intervals  that  the  raw,  heated  and  held  samples  were 
from  substantially  the  same  milk.  In  one  instance  samples  were 
also  taken  from  the  tank  where  the  pasteurized  milk  was  mixed 
before  bottling,  and  one  sample  was  also  taken  from  the  bottling 
machine.    The  results  of  the  analyses  are  shown  in  Table  VIII. 


291 


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292 

From  these  figures  it  can  be  a  irmed  that  commercial  pasteur- 
ization is  without  substantial  influence  upon  the  chemical  com- 
position of  milk  as  determined  by  the  methods  described  in  this 
investigation.  As  commercial  pasteurized  milk  is  not  the  ex- 
clusive product  of  a  two  or  three  cow  dairy,  but  represents  the 
mixed  milk  of  at  least  20  dairies  of  15  cows  each,  there  is  no 
necessity,  for  the  purpose  of  measuring  the  purity  of  this  milk, 
of  applying  figures  obtained  from  the  milk  of  a  few  abnormal 
cows  which  were  or  may  have  been  afflicted  with  diseased 
udders.  Samples  of  this  variety  may  possibly  be  obtained  from 
cows  which  are  under  forced  rations,  for  the  purpose  of  obtaining 
a  heavy  flow  of  milk  for  advanced  registry.  It  is  a  notable  fact 
that  cows  that  have  undergone  such  treatment  have  more  or  less 
udder  troubles,  and  may  not  subsequently  give  normal  milk. 
Commercial  pasteurized  milk  should  be  compared  with  the  milk 
from  herds  of  15  or  more  cows,  and  if  the  analytical  constants 
and  ratios  are  outside  of  what  under  these  circumstances  would 
be  expected,  the  sample  is  adulterated,  even  if  it  conforms  to 
analyses  of  many  samples  of  abnormal  milk  from  individual  cows. 

Conclusions. 

The  serum  of  milk,  skimmed  milk  and  cream  from  the  same 
source  is  identical.  Commercial  pasteurization  is  without 
influence  upon  the  components  of  milk  as  determined  by  the 
methods  employed  in  this  investigation.  Heating  milk  to  a 
temperature  of  150°  F.  or  65°  C.  and  above  for  a  period  of  three 
minutes  or  more  will  cause  a  coagulation  of  the  albumin,  and 
consequently  a  diminution  in  the  concentration  of  the  serum. 
Commercial  pasteurization  being  always  applied  to  large  volumes 
of  milk  representing  the  mixed  milk  of  many  herds,  it  is  not 
essential  to  use,  in  judging  the  quality  of  such  milk,  the  data 
obtained  from  individual  cows,  but  rather  from  herds.  Heating 
is  without  influence  upon  the  ash  of  the  serum  of  sour  milk,  or 
of  the  acetic  acid  serum  of  milk. 

The  thanks  of  the  authors  are  extended  to  Miss  Katherine  E. 
Rooney,  assistant  analyst  of  the  State  Department  of  Health, 
for  analytical  work  in  connection  with  the  investigation  of  the 
commercial  pasteurizing  process,  and  particularly  for  making  the 
bacteria  counts. 


293 


Appendix    F. 


STATUS  OF  LOCAL  MILK  INSPECTION. 

The  data  presented  in  the  following  pages  were  obtained,  first, 
from  the  questionnaire  submitted  to  local  boards  of  health  in  the 
spring  of  1915;  second,  from  the  information  gathered  by  the 
Food  and  Drug  Division  in  personal  visits  to  local  milk  in- 
spectors and  agents  of  local  boards  of  health  in  the  summer  of 
1915;  and  third,  from  repeated  correspondence  with  local  boards 
of  health,  in  which  fewer  and  simpler  questions  were  asked  than 
in  the  questionnaire,  in  the  early  autumn  of  1915.  The  State 
Department  of  Health  owes  its  sincere  thanks  to  those  employees 
of  local  boards  of  health  who  have  so  kindly  and  accurately 
answered  the  questions  submitted  to  them,  and  also  to  those 
who  so  willingly  permitted  access  to  their  official  records.  It  is 
believed  that  the  compilation  is  as  complete  as  it  is  possible  to 
obtain,  and  your  Board  has  on  file  all  the  data  which  it  has 
been  able  to  collect  in  this  State  relative  to  local  milk  inspection, 
from  which  data  this  compilation  has  been  made. 

The  varied  character  of  the  work  done  by  different  local 
boards  of  health  has  rendered  it  advisable  to  not  only  present 
the  compilation  alphabetically  by  cities  and  towns,  but  also  to 
divide  the  cities  and  towns  into  sections  according  to  the 
character  of  the  work  done.  The  first  attempt  resulted  in  25 
sections,  but  after  several  efforts  it  was  found  to  be  possible  to 
present  the  data  in  16  sections.  These  sections  are  arranged  in 
the  order  of  the  importance  of  the  work  done,  and  are  as  fol- 
lows :  — 

Section  1 .  —  Cities  and  towns  granting  licenses  and  permits,  inspecting 
dairies  and  making  chemical  and  bacteriological  examinations  of  milk. 

Section  2.  —  Cities  and  towns  granting  licenses  and  permits,  inspecting 
dairies  and  making  chemical  examinations. 

Section  3.  —  Cities  and  towns  having  milk  inspectors  who  grant  licenses, 
inspect  dairies  and  make  chemical  and  bacteriological  examinations. 

Section  4-  —  Cities  and  towns  granting  licenses  or  permits,  inspecting 
dairies  and  making  chemical  and  bacteriological  examinations. 

Section  5.  —  Cities  and  towns  granting  licenses  and  making  chemical 
and  bacteriological  examinations. 


294 

Section  6.  —  Cities  and  towns  making  chemical  and  bacteriological 
examinations  only. 

Section  7.  —  Cities  and  towns  granting  licenses  and  permits,  inspecting 
dairies  and  making  bacteriological  examinations. 

Section  8.  —  Cities  and  towns  granting  licenses,  inspecting  dairies  and 
making  chemical  examinations. 

Section  9.  —  Cities  and  towns  granting  licenses  and  making  chemical 
examinations. 

Section  10.  —  Cities  and  towns  granting  licenses  or  permits  and  in- 
specting dairies. 

Section  11.  —  Cities  and  towns  having  a  milk  inspector  and  granting" 
licenses  only. 

Section  12.  —  Cities  and  towns  in  which  the  inspector  was  recently 
appointed.  No  work  done  other  than  the  granting  of  a  few  licenses  or 
permits. 

Section  13.  —  Miscellaneous. 

Section  Uf.  —  Cities  and  towns  having  an  inspector  from  whom  no 
reply  could  be  obtained. 

Section  15.  —  Cities  and  towns  doing  no  milk  work  under  the  milk  in- 
spection laws. 

Section  16.  —  Cities  and  towns  from  which  no  information  could  be 
obtained. 

Section  1  comprises  17  cities  and  towns  which  carry  out  the 
law  as  the  statutes  contemplate.  From  the  data  given  it  may 
be  easily  ascertained  how  extensively  this  work  is  performed.  A 
bacteriologist  can  easily  make  from  50  to  100  bacteria  counts  per 
day,  and  a  competent  chemist  can  easily  make  from  30  to  50 
chemical  examinations  of  milk  per  day.  A  dairy  inspector 
cannot,  as  a  rule,  make  more  than  15  dairy  inspections  per  day 
if  carefully  carried  out.  In  order  to  effectively  supervise  the 
milk  supply  of  a  locality,  at  least  one  chemical  examination  and 
one  bacteriological  examination  should  be  made  each  month  of 
the  milk  of  each  dealer.  Several  samples  should  be  taken  at 
each  inspection.  This  work  requires  the  services  of  trained  men, 
and  many  localities  cannot  afford  the  necessary  expense. 

The  cities  and  towns  listed  under  section  2  carry  out  the 
statutory  provisions  relative  to  milk  inspection,  but  make  no 
bacteriological  examinations  as  do  those  localities  of  section  1, 
under  their  statutory  powers  to  make  and  enforce  bacteriological 
rules  and  regulations. 

The  22  localities  in  section  3  effectively  protect  their  communi- 
ties by  the  quality  of  the  work  performed,  but  do  not  grant 
permits  as  required  by  the  statutes. 


295 

The  5  towns  listed  in  section  4  perform  work  almost  essential 
in  character  to  those  in  section  1,  but  both  licenses  and  permits 
are  not  issued. 

The  3  towns  listed  in  section  5  do  not  enforce  dairy  inspection 
and  permit  laws,  but  if  the  work  done  is  performed  frequently 
and  properly  it  affords  good  protection  to  the  inhabitants. 

Section  6,  with  the  exception  of  licensing  the  dealers,  is  doing 
work  equivalent  to  those  localities  recorded  under  section  3. 

Section  7  consists  of  3  towns  which  are  carrying  out  all  the 
statutory  requirements  except  the  making  of  chemical  examina- 
tions for  the  detection  of  adulterations. 

Section  8,  comprising  5  localities,  makes  no  bacteriological 
examinations  and  issues  no  permits.  The  dairy  inspections,  as  a 
rule,  are  confined  to  local  dairies. 

Section  9  comprises  3  localities,  2  of  them  being  large  cities 
which  license  the  milk  dealers  and  make  chemical  examina- 
tions. 

Section  10  comprises  79  cities  and  towns,  and  is  the  largest 
section  except  that  doing  no  milk  work.  It  is  substantially 
carrying  out  the  provisions  of  chapter  744  of  the  Acts  of  1914 
relative  to  dairy  inspection.  Most  of  these  localities  raise  their 
own  milk  supply,  and  as  the  dairies  inspected  were  but  few,  the 
records  of  inspection  were  not  investigated  excepting  those 
instances  where  a  large  number  of  dairies  were  reported  to  have 
been  inspected.  In  some  instances,  however,  the  dairy  inspection 
was  confined  to  local  dairies  when  the  locality  imported  milk. 
The  dairy  inspections  were  made,  in  many  instances,  by  the 
inspector  of  animals  which,  while  not  strictly  conforming  to  the 
requirements  of  the  statutes,  were  no  doubt  done  as  well  as  if  a 
special  inspector  had  been  appointed  for  the  purpose.  In  other 
instances  the  members  of  the  board  of  selectmen  or  the  board  of 
health  performed  the  inspection  work. 

Section  11  consists  of  13  localities  which  have  milk  inspectors 
and  grant  licenses. 

Section  12  comprises  8  towns  which  have  recently  appointed 
an  inspector  of  milk.  No  work  has  been  done  other  than  the 
granting  of  a  few  licenses  or  permits. 

Section  13  comprises  7  localities  which  are  classed  as  miscel- 
laneous.   These  localities  grant  a  few  permits  and  one  license. 

Section  14  comprises  4  towns  having  a  milk  inspector  from 
whom  no  replies  could  be  received  from  a  letter  asking  for 
information  regarding  the  character  of  work  done. 


296 

Section  15  is  the  largest  section  and  comprises  159  localities 
doing  no  work  under  the  milk  inspection  laws. 

Section  16  comprises  10  towns  from  which  no  information 
could  be  received  in  response  to  numerous  inquiries.  No  doubt 
these  10  towns  belong  in  group  15,  which  would  raise  the 
number  of  towns  doing  no  work  to  172. 

The  figures  obtained  from  these  cities  and  towns  were  col- 
lected between  May  and  November  during  the  year  1915.  Most 
localities  doing  work  were  eager  to  allow  access  to  their  records, 
and  were  therefore  investigated  early  in  the  year.  The  figures 
for  dairy  inspection  obtained  from  these  cities  and  towns  are, 
therefore,  much  lower  than  they  would  have  been  had  they  been 
collected  in  October,  because  the  prevalence  of  the  hoof  and 
mouth  disease  during  the  winter  of  1914-15  had  the  effect  of 
curtailing  the  inspection  of  dairies.  This  was  not  resumed  until 
late  in  the  spring  of  1915.  In  fact,  many  localities  did  not 
begin  operations  under  the  dairy  inspection  law  of  1914  until 
the  summer  of  1915. 

In  the  preparation  of  this  portion  of  the  report  for  the  printer, 
it  was  decided  to  submit  to  each  city  and  town  a  statement  of 
what  the  Department  proposed  to  print.  Therefore  a  letter  was 
sent  stating  this  fact,  enclosing  a  form  upon  which  was  stated 
the  name  of  the  State  or  town,  the  number  of  licenses,  permits 
and  dairies  inspected  in  1914  and  1915,  the  character  of  the 
dairy  inspection,  a  statement  of  the  records  of  dairy  inspection, 
the  number  of  chemical  examinations,  and  the  number  of  bac- 
teriological examinations.  The  city  or  town  to  which  this  letter 
was  sent  was  requested  to  return  the  statement  saying  that  it 
was  correct,  or  to  return  it  stating  that  it  was  in  error,  with  a 
statement  of  how  the  corrected  report  should  read.  After  these 
replies  had  been  received  it  was  ascertained  that  in  a  few  in- 
stances there  was  a  discrepancy  between  the  reports  of  records 
of  dairy  inspection  as  brought  back  by  our  own  investigators 
and  as  claimed  by  the  local  men.  In  these  instances  the  local 
men  were  unable  at  the  time  of  visits  to  show  any  records  of 
their  dairy  inspections  to  the  Department's  employees.  A  few 
of  the  local  men  have  claimed  that  this  was  in  error,  and  that 
they  have  records  on  file  in  the  office.  Many  of  the  local  men, 
however,  admit  the  correctness  of  our  statements  that  they  had 
no  records  of  dairy  inspection.  A  large  number  of  cities  and 
towns  have  made  no  reply  to  this  last  letter  submitted. 


297 


(A)     Summary    of    Local    Milk    Inspection,    classified    by 
Cities  and  Towns. 

Section  1.  Cities  and  Towns  granting  Licenses  and  Permits,  in- 
specting Dairies  and  making  Chemical  and  Bacteriological 
Examinations. 

Amherst. 

16  licenses  granted. 

16  permits  granted. 

10  dairies  inspected. 
120  chemical  examinations  made. 
120  bacteriological  examinations  made. 

Boston. 
5,381  licenses  granted. 

Permits  at  present  being  granted. 
7,323  dairies  inspected. 
15,150  chemical  examinations  made. 

6,834  bacteriological  examinations  made.    Records  not  investigated  by- 
reason  of  the  difficulty  of  the  task. 

• 
Braintree. 

31  licenses  granted. 

21  permits  granted. 

31  dairies  inspected.  The  dairies  are  located  in  Braintree,  Randolph 
and  Weymouth.  Dairies  of  the  Barden  Cream  Company  not 
investigated.  Dairy  inspection  made  for  general  cleanliness  and 
recorded  as  fair,  passed,  good,  etc. 

36  chemical  examinations  made. 

12  bacteriological  examinations  made. 

Brockton. 
462  licenses  granted. 
192  permits  granted. 

242  dairies  inspected,  located  in  Avon,  Brockton,  Stoughton,  Bridge- 
water,  Abington,  East  Bridge  water  and  Randolph.  Some  of 
these  dairies  scored  exceptionally  low,  the  average  of  all  the 
dairies  being  slightly  below  50.  The  bacterial  analyses  show 
the  milk  sold  to  be  of  good  quality. 
1,524  chemical  examinations  made. 
2,080  bacteriological  examinations  made. 


298 


Brookline. 

140  licenses  granted. 

339  permits  granted. 

354  dairies  inspected.  Dairy  inspection  made  on  special  score  card. 
Brookline  has  inspected  the  dairies  of  the  large  contractors  lo- 
cated in  New  Hampshire,  Vermont,  Maine  and  western  Massa- 
chusetts, and  has  inspected  nearly  all  the  dairies  of  the  smaller 
dealers.  The  contractors  are  obliged  to  furnish  milk  from  special 
dairies  approved  by  the  agent  of  the  board  of  health.  In  doing 
this  work  the  territory  covered  by  Boston  and  Newton  has  been 
duplicated.  Some  of  the  inspections  have  been  made  in  col- 
laboration with  the  Newton  Board  of  Health. 

470  chemical  examinations  made. 

534  bacteriological  examinations  made. 

Fall  River. 

741  licenses  granted. 

407  permits  granted. 

412  dairies  inspected.  The  dairies  are  located  in  Berkley,  Dighton, 
Fall  River,  Dartmouth,  Somerset,  Swansea,  Rehoboth,  Tiverton, 
R.  I.,  Portsmouth,  R.  I.,  Little  Compton,  R.  I.,  and  Warren, 
R.  il  There  does  not  seem  to  be  any  duplication  of  the  work  by 
other"  cities  or  towns  in  making  these  inspections. 

214  chemical  examinations  made. 
2,286  bacteriological  examinations  made. 

Haverhill. 
42  licenses  granted. 
110  permits  granted. 

26  dairies  inspected,  located  in  Haverhill  and  Bradford.    No  attempt 
made  to  inspect  dairies  outside  of  the  city  except  one  dairy  in 
Salem,  N.  H.    Considerable  cream  sold  by  Turner  Centre  Dairy- 
ing Association.    Dairies  not  inspected. 
314  chemical  examinations  made. 
2,103  bacteriological  examinations  made. 

Lancaster. 
9  licenses  granted. 
40  permits  granted. 

48  dairies  in  Lancaster  inspected.    United  States  score  cards  used. 
19  chemical  examinations  made. 
32  bacteriological  examinations  made. 


299 


Lawrence. 
82  licenses  granted. 
42  permits  granted. 
175  dairies  inspected,  located  in  Methuen,  Andover,  North  Andover 

and  Dracut.    Inspection  made  for  general  cleanliness. 
217  chemical  examinations  made. 
125  bacteriological  examinations  made. 

Milton. 
36  licenses  granted.    A  few  permits  granted. 

25  dairies  inspected.    Score  card  used  in  inspecting  dairies  located  in 
Milton.    Dairies  of  the  H.  P.  Hood  Company,  the  Elm  Farm 
Company  and  Barden  Cream  Company  not  known  or  inspected. 
297  chemical  examinations  made. 
103  bacteriological  examinations  made. 

Natick. 
57  licenses  granted. 
65  permits  granted. 
76  dairies  inspected,  located  in  Sherborn,  Framingham,  Ashland,  Hol- 

liston,  Wayland,  Dover,  Sudbury  and  Natick. 
30  chemical  examinations  made. 
4  bacteriological  examinations  made. 

Newton. 

178  licenses  granted. 

435  permits  granted. 

666  dairies  inspected.  Dairies  located  around  Newton,  and  contractors' 
dairies  in  New  Hampshire,  Vermont  and  western  Massachusetts. 
Inspections  made  by  United  States  score  cards  and  records  kept. 
Work  of  the  Boston  Board  of  Health  and  Brookline  Board  of 
Health  has  been  duplicated  by  Newton.  Some  of  the  inspections, 
however,  have  been  made  in  collaboration  with  the  Brookline 
Board  of  Health. 

821  chemical  examinations  made. 

198  bacteriological  examinations  made. 

Somerville. 

610  licenses  granted. 

336  permits  granted. 

354  dairies  inspected.  Dairies  of  large  contractors  not  inspected.  Some 
of  the  out-of-State  dairies  of  the  smaller  contractors  inspected, 
going  over  the  territory  covered  by  Newton,  Brookline  and 


300 

Boston.  Inspection  scores  of  the  State  accepted,  and  also  in- 
spections of  Boston,  Waltham  and  Arlington  when  available. 
The  inspector  relies  more  upon  microscopical  examination  and 
bacteria  count  of  milk  than  upon  dairy  inspection. 

3,008  chemical  examinations  made. 

1,143  bacteriological  examinations  made. 

Springfield. 
732  licenses  granted. 
78  permits  granted.  Permits  have  been  issued  by  regulations  of  the 
city  Board  of  Health  before  the  passage  of  the  1914  law.  New 
permits  issued  during  1914. 
997  dairies  inspected.  Dairies  were  inspected  by  the  score  card  method, 
the  Department  covering  practically  all  the  dairies  supplying 
milk  to  the  city.  Dairies  are  located  in  Agawam,  Amherst, 
Becket,  Deerfield,  Enfield,  Granby,  Greenfield,  Greenwich,  Had- 
ley,  Hampden,  Hardwick,  Huntington,  Longmeadow,  Ludlow, 
Middlefield,  Monson,  Montgomery,  Palmer,  Prescott,  Savoy, 
Southwick,  Warren,  Washington,  Westfield,  West  Springfield, 
Whately,  Wilbraham  and  in  Ellington,  Hazardville,  Somers  and 
Suffield,  Conn.  Springfield  reports  that  the  milk  from  many  of 
these  dairies,  which  was  refused  admission  to  Springfield,  is  be- 
ing sold  in  surrounding  towns.  No  other  cities  or  towns  have 
inspected  these  dairies  to  the  knowledge  of  the  Springfield  Board 
of  Health.  The  territory,  however,  where  the  dairies  are  located 
has  been  covered  by  inspectors  of  other  cities  or  towns. 

2,697  chemical  examinations  made. 

1,120  bacteriological  examinations  made. 

Westfield. 

17  licenses  granted. 

57  permits  granted. 
110  dairies  inspected. 
204  chemical  examinations  made. 

23  bacteriological  examinations  made. 

Winchendon. 

34  licenses  granted. 
28  permits  granted. 

207  dairies  inspected.     Dairies  located  in  Winchendon.     Inspections 

made  by  means  of  United  States  score  card. 
297  chemical  examinations  made  consisting  of  fat  and  sediment  tests. 

35  bacteriological  examinations  made. 


301 


Winchester. 
49  licenses  granted. 
38  permits  granted. 

92  dairies  inspected.    Inspection  made  by  United  States  score  card 
method  of  dairies  located  in  Woburn,  Stoneham,  Winchester, 
Short  Falls,  N.  H.,  Wilton,  N.  H.,  and  Milford,  N.  H.    The 
extra-State  dairies  supply  milk  to  Hood  and  Whiting. 
165  chemical  examinations  made. 
165  bacteriological  examinations  made. 


Section  2.     Cities  and  Towns  granting  Licenses  and  Permits, 
inspecting  Dairies  and  making  Chemical  Examinations. 

Amesbury. 
6,3  licenses  granted. 
42  permits  granted. 
92  dairies  inspected.     Dairy  inspection  consists  of  examination  for 

general  cleanliness. 
29  chemical  examinations  made.    Chemical  examination  for  fat  only. 


Arlington. 
82  licenses  granted. 
12  permits  granted. 
90  dairies  inspected. 
200  chemical  examinations  made. 

Athol. 
20  licenses  granted. 
20  permits  granted. 

30  dairies  inspected.    Dairies  inspected  for  general  cleanliness.    Rec- 
ords show  dairies  to  be  good  or  poor. 
24  chemical  examinations  for  fat. 


Barnstable. 
167  licenses  granted. 
126  permits  granted. 
169  dairies  inspected. 

80  chemical  examinations  consisting  of  fat  and  specific  gravity.  Ex- 
aminations made  for  general  cleanliness.  Rules  and  regulations 
of  the  board  of  health  require  all  dealers  to  obtain  licenses  and 
pay  for  the  same. 


302 


Chicopee. 
112  licenses  granted. 
62  permits  granted. 

62  dairies  inspected.   Special  card  used  for  inspection  on  general  clean- 
liness. 
285  chemical  examinations  consisting  of  fat  determination. 

Greenfield.    , 

20  licenses  granted. 

20  permits  granted. 

35  dairies  inspected.  Dairies  inspected  twice  a  year  for  general  clean- 
liness.   Score  card  occasionally  used. 

90  chemical  examinations  made.  Chemical  examinations  consist  of 
specific  gravity  and  fat. 

Hingham. 
10  licenses  granted. 
20  permits  granted. 

20  dairies  inspected.    Dairy  inspection  of  general  cleanliness  confined 
to  dairies  in  town. 
1  chemical  examination  made. 

Hull. 
30  licenses  granted. 
4  permits  granted. 

4  dairies  inspected.  Dairy  inspection  made  for  general  cleanliness. 
Inspector  does  not  know  from  how  many  dairies  the  town  obtains 
its  milk.  Dairies  of  the  Deerfoot  Farm  and  Whiting  have  not 
been  inspected.  • 

70  chemical  examinations  made.  .Chemical  examinations  consist  of 
fat  determination. 

Montague. 
26  licenses  granted. 
26  permits  granted. 

4  dairies  inspected. 

5  or  6  chemical  examinations  made. 

North  Adams. 
89  licenses  granted. 
75  permits  granted. 

182  dairies  inspected.     United  States  score  card  used  in  inspecting 
dairies.    Dairies  are  scored  in  the  spring  and  fall.    Nearly  all  the 
dairies  have  been  inspected. 
340  chemical  examinations  for  fat. 


303 


Provincetown. 
30  licenses  granted. 
39  permits  granted. 

21  dairies  inspected,  located  in  Provincetown  and  Truro.     General 

inspection  made  and  also  United  States  score  card  used.    In- 
spection made  by  the  State  at  the  request  of  the  Provincetown 
Board  of  Health. 
14  chemical  examinations  made. 

Wakefield. 

22  licenses  granted. 

22  permits  granted. 

12  dairies  inspected.    Dairies  located  in  Exeter  and  Epping,  N.  H., 

North  Reading,  Lynnfield,  Wakefield  and  Melrose. 
100  chemical  examinations  made. 

Ware. 
55  licenses  granted. 
64  permits  granted. 
142  dairies  inspected.    Dairies  inspected  every  three  months  but  not 

scored. 
488  chemical  examinations  for  fat. 

Wdburn. 
107  licenses  granted. 

105  permits  granted  to  those  taking  out  licenses. 
Ill  dairies  inspected.    Dairies  of  D.  Whiting  &  Co.  not  inspected. 
Ill  chemical  examinations  made  consisting  of  fat  and  specific  gravity. 

Section  3.  Cities  and  Towns  having  Milk  Inspectors  who  grant 
Licenses,  inspect  Dairies  and  make  Chemical  and  Bacterio- 
logical Examinations. 

Belmont. 
41  licenses  granted. 

61  dairies  inspected,  located  in  10  different  cities  and  towns  in  the 
State. 
230  chemical  examinations  made. 
230  bacteriological  examinations  made. 
Records  not  investigated. 

Cambridge. 
700  licenses  granted 

23  dairies  (local)  inspected. 
2,300  chemical  examinations  made: 

842  bacteriological  examinations  made. 


304 


Canton. 
25  licenses  granted. 

Permits  granted  on  strength  of  previous  year's  examination. 
29  dairies  inspected,  located  in  Canton  and  Stoughton. 
209  chemical  examinations  made. 
228  bacteriological  examinations  made. 

Chelsea. 
261  licenses  granted. 
18  dairies  inspected.    Inspection  limited  to  local  dairies.    The  bulk  of 
the  milk  sold  in  Chelsea  comes  from  the  large  contractors. 
226  chemical  examinations  made. 
61  bacteriological  examinations  made. 

Cohasset. 
12  licenses  granted. 

6  dairies  inspected,  located  in  Cohasset  and  Scituate. 
10  chemical  examinations  made. 
29  bacteriological  examinations  made. 

Concord. 
15  licenses  granted. 
15  dairies  inspected,  located  in  Concord  and  Littleton. 

5  chemical  examinations  made. 

1  bacteriological  examination  made. 

Dedham. 
24  licenses  granted. 
51  dairies  inspected,  located  in  Dedham,  Westwood,  Norwood,  Dover 

and  Needham. 
226  chemical  examinations  made. 
51  bacteriological  examinations  made. 

Fitchburg. 
110  licenses  granted. 
114  dairies  inspected. 
377  chemical  examinations  made. 
76  bacteriological  examinations  made. 

Framingham. 
29  licenses  granted. 

87  dairies  inspected,  located  in  Framingham,  Holliston,  Ashland,  Sud- 
bury and  Wayland. 
150  chemical  examinations  made. 
232  bacteriological  examinations  made. 


305 


Gardner. 
43  licenses  granted. 

120  dairies  inspected,  located  in  Gardner,  Winchendon,  Ashburnham, 
Westminster,  Hubbardston,  Templeton,  Phillipston,  East  Jaf- 
frey,  N.  H.,  and  East  Rindge,  N.  H. 
379  chemical  examinations  made. 
48  bacteriological  examinations  made. 

Holyoke. 
454  licenses  granted.    20  permits  refused. 

265  dairies  inspected,  located  in  Holyoke,  Amherst,  Sunderland,  West- 
field,  Southampton,  Hadley,  Granby,  Belchertown,  South  Deer- 
field,  Whately  and  Hatfield.  These  inspections,  however,  were 
made  by  the  State  Department  of  Health  at  the  request  of  the 
Holyoke  Board  of  Health.  Local  board  now  making  all  dairy 
inspections. 
2,543  chemical  examinations  made. 
40  bacteriological  examinations  made. 

Lynn. 
587  licenses  granted. 
1,034  dairies  inspected,  located  in  cities  and  towns  surrounding  Lynn, 
dairies  in  Maine  including  Auburn  and  Lewiston,  also  dairies  in 
the  neighborhood  of  Portsmouth,  N.  H.    General  inspection  of 
dairies  show  the  dairy  to  be  good,  fair  and  poor. 
2,024  chemical  examinations  made. 
320  bacteriological  examinations  made. 

Maiden. 
261  licenses  granted. 
190  dairies  inspected;  75  per  cent,  of  the  milk  comes  from  out  of  the 

State,  and  the  dairies  have  not  been  inspected  by  the  city  of 

Maiden. 
563  chemical  examinations  made. 
103  bacteriological  examinations  made. 

Medford. 
183  licenses  granted. 
15  dairies  inspected. 
237  chemical  examinations  made. 
3  bacteriological  examinations  made. 


306 


Melrose. 
71  licenses  granted. 

45  dairies  inspected,  located  in  Melrose,  Saugus,  Wakefield,  Reading 
and  Wilmington.     The  large  contractors  furnish  about  one- 
quarter  of  the  milk  supply,  and  these  dairies  have  not  been  in- 
spected. 
285  chemical  examinations  made. 
356  bacteriological  examinations  made. 

New  Bedford. 
452  licenses  granted. 

181  dairies  inspected.    The  inspection  limited  to  local  dairies  except  in 
rare  cases.    Score  card  used,  records  as  shown  refer  to  dairies  as 
good,  fair,  etc. 
24  chemical  examinations  made. 
698  bacteriological  examinations  made. 

Quincy. 
193  licenses  granted. 

68  dairies  inspected  located  in  Quincy.    Dairies  of  the  large  contractors 
not  inspected;  recorded  as  good,  fair,  poor,  very  poor,  etc.    Some 
marked  "very  poor"  are  apparently  selling  milk. 
8  chemical  examinations  made. 
8  bacteriological  examinations  made. 

Revere. 
18  licenses  granted. 

8  local  dairies  inspected  for  general  sanitary  conditions.    Dairies  of 
large  contractors  who  furnish  most  of  the  milk  not  inspected. 
124  chemical  examinations  made. 
62  bacteriological  examinations  made. 

Salem. 
239  licenses  granted. 
80  dairies  inspected.    United  States  score  card  used  in  inspecting 

dairies. 
874  chemical  examinations  made. 
874  bacteriological  examinations  made. 

Taunton. 
84  licenses  granted. 
195  dairies  inspected,  located  in  Taunton,  Dighton,  Berkley,  Raynham, 

Norton  and  Rehoboth;  recorded  as  good,  fair,  etc. 
100  chemical  examinations  for  fat. 
75  bacteriological  examinations  made. 


307 


Waltham. 
152  licenses  granted. 

180  dairies  inspected,  located  in  Waltham,  Lexington,  Lincoln,  Bed- 
ford,  Wilmington,   Weston,   Wayland,    Sudbury,   Stow,   Box- 
borough,  Harvard,  Littleton,  Acton  and  Groton. 
1,400  chemical  examinations  made. 
427  bacteriological  examinations  made. 

Worcester. 
193  licenses  granted. 

200  dairies  inspected.    United  States  score  card  used. 
1,653  chemical  examinations  made. 
281  bacteriological  examinations  made.  , 


Section  4.  Cities  and  Towns  granting  Licenses  or  Permits,  in- 
specting Dairies  and  making  Chemical  and  Bacteriological 
Examinations. 

Clinton. 
53  licenses  granted. 

66  dairies  inspected.    United  States  score  card  used.    Good  records. 
50  chemical  examinations  made. 
133  bacteriological  examinations  made. 

Watertown. 

72  licenses  granted. 

27  dairies  inspected. 
339  chemical  examinations  made. 
113  bacteriological  examinations  made. 

Wellesley. 
34  licenses  granted. 
43  dairies  inspected. 
87  chemical  examinations  made. 
153  bacteriological  examinations  made. 


Westborough. 
55  permits  granted. 

55  dairies  inspected.    Inspector  is  a  veterinarian. 
20  chemical  examinations  made.    Chemical  examinations  limited  to 

fat,  specific  gravity  and  sediment  test. 
25  bacteriological  examinations  made. 


308 


Weston. 
13  licenses  granted. 
24  dairies  inspected. 

43  chemical  examinations  made. 

125  bacteriological  examinations  made. 

Section  5.    Cities  and  Towns  granting  Licenses  and  making  Chem- 
ical and  Bacteriological  Examinations. 

Needham. 
11  licenses  granted. 
48  chemical  examinations  made. 
87  bacteriological  examinations  made. 

Swampscott. 

44  licenses  issued. 

58  chemical  examinations  made. 

24  bacteriological  examinations  made. 

Winthrop. 

51  licenses  granted. 

130  chemical  and  bacteriological  examinations  made. 

Section  6.    Cities  and  Towns  making  Chemical  and  Bacteriological 
Examinations  only. 

Walpole. 
35  chemical  examinations  made. 
35  bacteriological  examinations  made. 

Section  7.    Cities  and  Towns  granting  Licenses  and  Permits,  in- 
specting Dairies  and  making  Bacteriological  Examinations. 

Scituate. 
16  licenses  granted. 
22  permits  granted. 
7  dairies  inspected,  location  in  Scituate.    General  inspection  made. 

Records  show  dairies  to  be  very  good  or  good. 
7  bacteriological  examinations  made. 

Stoneham. 
50  licenses  granted. 

52  permits  granted.  N 

18  dairies  inspected.    Dairies  of  large  contractors  not  inspected. 
100  bacteriological  examinations  made. 


309 


Whitman. 
17  licenses  granted. 
27  permits  granted. 
32  dairies  inspected.    Dairy  inspection  made  for  general  cleanliness. 

Records  show  dairies  to  be  good,  poor  or  fair. 
38  bacteriological  examinations  made. 


Section  8.    Cities  and  Towns  granting  Licenses,  inspecting  Dairies 
and  making  chemical  examinations. 

Adams. 
26  licenses  granted. 

45  dairies  inspected.    Dairy  inspection  for  general  cleanliness. 
150  chemical  examinations  for  fat. 

Attleboro. 

32  licenses  granted. 

65  dairies  inspected.  Dairy  inspection  carried  on  by  United  States 
score  card.  Records  shown  to  investigator.  Laboratory  appa- 
ratus consisting  of  babcock  machine,  balance  platinum  dishes. 

33  chemical  examinations  made. 


Beverly. 
164  licenses  granted. 
34  dairies  inspected.    Unable  to  state  from  how  many  different  dairies 

the  city  obtains  its  milk. 
64  chemical  examinations  made. 

Lexington. 
44  licenses  granted. 
20  dairies  inspected. 
100  chemical  examinations  made. 

Pittsfteld. 
68  licenses  granted. 

40  dairies  inspected.    Dairy  inspection  consists  of  inspection  for  gen- 
eral cleanliness.    Recorded  as  fair,  bad  and  good.    Dairy  inspec- 
tion confined  to  Pittsfield. 
300  chemical  examinations  for  fat. 


310 


Section  9.    Cities  and  Towns  granting  Licenses  and  making  Chem- 
ical Examinations. 

Everett. 
335  licenses  granted. 
700  chemical  examinations  made. 

Lowell. 
600  licenses  granted. 
2,226  chemical  examinations  made. 

Plainville. 
9  licenses  granted. 
48  chemical  examinations  for  fat. 


Section  10.    Cities  and  Towns  granting  Licenses  or  Permits  and 
inspecting  Dairies. 

Acton. 
16  licenses  granted. 
16  permits  granted. 

16  dairies  inspected. 

Acushnet. 
4  licenses  granted. 
14  permits  granted. 
14  dairies  inspected. 

Inspector  appointed  May  10,  1914. 

Ashby. 
3  permits  granted. 
3  dairies  inspected. 

Ashland. 

17  permits  granted. 

14  dairies  inspected,  located  in  Ashland  and  Hopkinton. 


21  permits  granted. 
24  dairies  inspected. 

32  permits  granted. 
32  dairies  inspected. 


Avon. 


Barre. 


Belchertown. 


3  permits  granted. 

3  dairies  inspected.    Records  not  investigated. 


311 


Bellingham. 

2  permits  granted. 

5  dairies  inspected.    Records  not  investigated. 

Boxford. 
13  permits  granted. 
13  dairies  inspected.    Records  not  investigated. 

Bridgewater. 
21  licenses  granted. 

4  permits  granted. 

8  dairies  inspected,  located  in  Bridgewater.    Most  of  the  dairies  in- 
spected reported  as  clean,  fairly  clean,  etc. 

Buckland. 
7  permits  granted. 
7  dairies  inspected.    Records  not  investigated. 

Charlemont. 

5  permits  granted. 
5  dairies  inspected. 

Chilmark. 
20  permits  granted. 
20  dairies  inspected.    General  inspection  passable  or  not  passable. 

Conway. 
1  license  granted. 
1  permit  granted. 
1  dairy  inspected. 

Dalton. 

3  licenses  granted. 
10  permits  granted. 

12  dairies  inspected.    United  States  score  cards  used. 

Dana. 
7  permits  granted. 
7  dairies  inspected.    General  inspection. 

Danvers. 
51  licenses  granted. 
58  permits  granted. 
60  dairies  inspected. 

Dover. 
10  permits  granted. 
10  dairies  inspected.    Inspection  made  for  general  cleanliness. 


312 


Eastham. 


Easthampton. 


Duxbury. 
94  permits  granted. 

94  dairies  inspected.    Dairies  inspected  by  United  States  score  card 
and  records  kept.    Nearly  all  the  dealers  have  permits. 

East  Longmeadow. 

3  licenses  granted. 
14  dairies  inspected. 

38  permits  granted. 
38  dairies  inspected. 

17  licenses  granted. 
7  dairies  inspected. 

Edgartown. 
26  permits  granted. 

26  dairies  inspected.    Inspection  made  in  collaboration  with  Dairy 
Bureau. 

Foxborough. 
29  permits  granted. 
25  dairies  inspected.    Records  not  investigated. 

r 

Gloucester. 
123  licenses  granted. 
44  permits  granted. 

112  dairies  inspected,  located  in  Gloucester,  Rockport,  Essex,  Ipswich 
and  Manchester. 

Gosnold. 

4  permits  granted. 
4  dairies  inspected. 

Great  Barrington. 

18  licenses  granted. 
24  dairies  inspected. 

Inspection  made  by  means  of  score  card. 


77  permits  granted. 
77  dairies  inspected. 

11  licenses  granted. 

4  permits  granted. 

11  dairies  inspected. 

11  dairies  inspected. 


Groton. 


Halifax. 


Hamilton. 


313 


Hanson. 


Holland. 


Hopkinton. 


Hudson. 


10  permits  granted. 

10  dairies  inspected. 

2  or  3  licenses  granted. 
2  or  3  dairies  inspected. 

54  permits  granted. 
44  dairies  inspected. 

14  licenses  granted. 
14  dairies  inspected. 

Ipswich. 

29  licenses  granted. 

46  dairies  inspected.    Inspection  for  general  cleanliness. 

Lee. 
Number  of  permits  issued  not  recorded. 
175  dairies  inspected.    Inspection  made  for  general  cleanliness. 

Lenox. 

11  licenses  granted. 

24  dairies  inspected.  The  dairies  are  scored  for  general  cleanliness. 
The  inspector  is  also  a  policeman. 

Ludlow. 

30  licenses  granted. 
60  permits  granted. 

60  dairies  inspected.  Town  obtains  milk  from  8  different  towns,  but 
all  of  these  dairies  have  been  inspected  by  the  Springfield  Board 
of  Health. 

Marblehead. 
79  licenses  granted. 

27  local  dairies  inspected.  Dairies  visited  two  or  three  times  a  year. 
Score  card  used  in  making  inspections.  Only  local  dairies  in- 
spected. 

Marion. 
10  permits  granted. 
5  dairies  inspected. 

Marlborough. 
73  licenses  granted. 
10  dairies  inspected. 
The  city  obtains  its  milk  from  55  different  dairies,  and  also  obtains 
milk  from  the  Deerfoot  Farm. 


314 


Maynard. 
11  licenses  granted. 

25  dairies  inspected.     Recommendations  made  to  dairymen  at  the 

time  of  visit. 

Medway. 
34  permits  granted. 
34  dairies  inspected.    Records  not  investigated. 

Middleborough. 
85  licenses  and  permits  granted. 
88  dairies  inspected. 

-Millis. 
3  permits  granted. 
3  dairies  inspected.    Records  not  investigated. 

Monson. 
10  licenses  granted. 
3  dairies  inspected. 

Nantucket. 
37  licenses  granted. 
37  permits  granted. 

26  dairies  inspected,  located  in  Nantucket. 


50  licenses  granted. 
12  permits  granted. 
58  dairies  inspected. 

7  licenses  granted. 
16  permits  granted. 
20  dairies  inspected. 

33  permits  granted. 
29  dairies  inspected. 


North  Attleborough. 

North  Brookfield. 

North  Reading. 
Northampton. 


55  licenses  granted. 
114  permits  granted. 

125  dairies  inspected,  located  in  Northampton  and  surrounding  towns. 
Inspections  made  by  United  States  score  cards  and  complete 
records  available. 

Norton. 
130  permits  granted. 
130  dairies  inspected. 


315 


Norwell. 
65  permits  granted. 
65  dairies  inspected.    Score  cards  used. 

Norwood. 
4  licenses  granted. 
43  permits  granted. 

43  dairies  inspected,  located  in  Norwood.    Inspection  made  by  United 
States  score  cards  and  records  available. 

Orange. 
36  permits  granted. 

36  dairies  inspected.    General  inspection  for  cleanliness.    Recorded  as 
passed  or  not  passed. 

Orleans. 
50  permits  granted. 

50  dairies  inspected.    Records  not  investigated. 

Palmer. 
70  licenses  granted. 
70  permits  granted. 

135  dairies  inspected,  located  in  Palmer,  Belchertown,  Monson  and 
Ware.  General  inspection  made  and  dairies  recorded  as  fair, 
good  or  bad. 

Peabody. 
98  licenses  granted. 
19  permits  granted. 
100  dairies  inspected.    No  data  kept  of  inspection;  figures  given  to  the 
investigator  entirely  from  memory.     Dairies  inspected  are  lo- 
cated in  Peabody. 

Petersham. 
8  permits  granted. 
24  dairies  inspected.     United  States  score  cards  used.     Records  of 
scores  on  file. 

Plymouth. 

51  licenses  granted. 
60  dairies  inspected. 

41  permits  granted. 
41  dairies  inspected. 

26  licenses  granted. 
18  dairies  inspected. 


Rowley. 
Salisbury. 


316 


Sandwich. 

10  permits  granted. 

20  dairies  inspected.    Inspection  for  general  cleanliness  made. 

Saugus. 
59  licenses  granted. 
59  permits  granted. 
43  local  dairies  inspected.    Inspections  made  for  general  cleanliness. 

Sherborn. 
94  licenses  granted. 
94  dairies  inspected.    Records  not  investigated. 

Shirley. 

11  permits  granted. 
11  dairies  inspected. 

Somerset. 

1  license  granted. 

All  dairies  inspected. 

Southbridge. 

29  licenses  granted. 
37  permits  granted. 

30  dairies  inspected.    Dairy  inspections  made  by  United  States  score 

cards.    Dairies  located  in  Sturbridge,  Charlton,  Southbridge. 
Records  on  file. 

Spencer. 
16  licenses  granted. 
27  permits  granted. 

27  dairies  inspected,  located  in  Spencer  and  Leicester.  Records  of 
inspection  not  investigated. 

Stochbridge. 
19  licenses  granted. 
19  permits  granted. 
19  dairies  inspected. 

Stoughion. 

2  licenses  granted. 

31  permits  granted. 

33  dairies  inspected.  One  dairy  located  in  Sharon,  the  balance  in 
Stoughton.  Four  dairies  reported  in  bad  condition.  Records 
not  shown  to  investigator. 


317 


Sturbridge. 


20  permits  granted. 

Records  not  investigated. 


Sunderland. 


2  permits  granted. 
2  dairies  inspected. 


Vxbridge. 
5  permits  granted. 
5  dairies  inspected.    Records  not  investigated. 

Wareham. 
26  licenses  granted. 
81  permits  granted. 
80  dairies  inspected  by  inspector  of  animals. 

West  Boylston. 
4  permits  granted. 
7  dairies  inspected.    Records  not  investigated. 


15  permits  granted. 
15  dairies  inspected. 

8  licenses  granted. 
24  permits  granted. 
24  dairies  inspected. 

24  permits  granted. 
19  dairies  inspected. 


Westport. 


Williamstown. 


Wilmington. 


Section  11.    Cities  and  Towns  having  a  Mile:  Inspector  and  grant- 
ing Licenses  only. 


Andover. 

Ashburnham. 

Ayer. 

Fairhaven. 

Falmouth. 

Leominster. 

Methuen. 


Rockland. 

Topsfield. 

Warren. 

West  Springfield. 

Westwood. 

Weymouth. 


318 


Section  12.  Cities  and  Towns  in  which  the  Inspector  was  recently 
appointed.  No  Work  done  Other  than  the  Granting  of  a  Few 
Licenses  or  Permits. 

Billerica. 
Inspector  recently  appointed.    Records  not  investigated. 

Franklin. 
Milk  inspector  reports  that  no  work  has  been  done.     Inspector 
appointed  during  the  summer  of  1915. 

Grafton. 
Inspector  appointed  during  the  summer  of  1915. 
8  dairies  inspected. 

Lunenburg. 
No  licenses  or  permits  granted.    No  dairies  inspected.    Inspector 
stated  that  no  appropriation  was  made  to  carry  out  the  work. 

Marshfield. 
Inspector  appointed  in  the  spring  of  1915  and  has  done  no  work. 

Northborough. 
Inspector  recently  appointed.    No  work  done. 

Pepperell. 
12  licenses  granted. 
12  permits  granted.    Records  not  investigated. 

Randolph. 
Inspector  recently  appointed. 

Section  13.    Miscellaneous. 

Becket. 
No  inspector. 
1  license  granted.     Records  not  investigated. 

Milford. 
Some  dairies  inspected. 

Newburyport. 
4A  licenses  granted. 
400  bacteriological  examinations  made. 


18  permits  granted. 
10  dairies  inspected. 


319 

Plympton. 

Rowe. 

Southampton. 


No  inspector. 
4  permits  granted. 

Upton. 
7  permits.    No  dairies  inspected. 


Section  14. 

Carlisle. 
Rutland. 

Section  15. 

Abington. 

Agawam. 

Alford. 

Ashfield. 

Auburn. 

Bedford. 

Berkley. 

Berlin. 

Bernardston. 

Blackstone. 

Blandford. 

Bourne. 

Boxborough. 

Boylston. 

Brewster. 

Brimfield. 

Brookfield. 

Burlington. 

Carver. 

Charlton. 

Chatham. 

Chelmsford. 

Cheshire. 

Chester. 

Chesterfield. 

Clarksburg. 


Cities  and  Towns  having  an  Inspector  prom  whom  no 
Reply  could  be  obtained. 

South  Hadley. 
Sutton. 

Cities  and  Towns  doing  no  Milk  Work  under  the 
Milk  Inspection  Laws. 


Colrain. 

Hancock. 

Cummington. 

Hanover. 

Dartmouth. 

Hardwick. 

Deerfield. 

Harvard. 

Dennis. 

Harwich. 

Dighton. 

Hatfield. 

Douglas. 

Hawley. 

Dracut. 

Heath. 

Dudley. 

Hinsdale. 

Dunstable. 

Holbrook. 

East  Bridgewater. 

Holden. 

Egremont. 

Holliston. 

Enfield. 

Hopedale. 

Erving. 

Hubbardston. 

Essex. 

Huntington. 

Florida. 

Kingston. 

Freetown. 

Lakeville. 

Georgetown. 

Lanesborough 

GiU. 

Leicester. 

Goshen. 

Leverett. 

Granby. 

Leyden. 

Granville. 

Lincoln. 

Greenwich. 

Longmeadow. 

Groveland. 

Lynnfield. 

Hadley. 

Manchester. 

Hampden. 

Mansfield. 

320 


Mashpee. 

Peru. 

Tisbury. 

Mattapoisett. 

Phillipston 

Tolland. 

Medfield. 

Plainfield. 

Townsend. 

Mendon. 

Prescott. 

Truro. 

Merrimac. 

Raynham. 

Tyngsborongh. 

Middlefield. 

Reading. 

Tyringham. 

Middleton. 

Rehoboth. 

Wales. 

Monroe. 

Richmond 

Warwick. 

Monterey. 

Rochester. 

Washington. 

Montgomery. 

Rockport. 

Wayland. 

Mount  Washington. 

Royalston 

Webster. 

Nahant. 

Russell. 

WeUfleet. 

New  Ashford. 

Sandisfielc 

L 

WendeU. 

New  Braintree. 

Savoy. 

West  Bridgewater. 

New  Marlborough. 

Seekonk. 

West  Brookfield. 

New  Salem. 

Sharon. 

West  Newbury. 

Newbury. 

Sheffield. 

West  Stockbridge. 

Norfolk. 

Shelburne 

West  Tisbury. 

North  Andover. 

Shrewsbury. 

Westford. 

Northbridge. 

Shutesbury. 

Westhampton. 

Northfield. 

Southborough. 

Westminster. 

Oak  Bluffs. 

Southwick 

Whately. 

Oakham. 

Sterling. 

Wilbraham. 

Otis. 

Stow. 

Windsor. 

Oxford. 

Swansea. 

Worthington. 

Pelham. 

Templeton. 

Wrentham. 

Pembroke. 

Tewksbury. 

Yarmouth. 

Section  16.    Cities  a 

nd  Towns  from  which  no  Information  cot 

BE   OBTAINED. 

Bolton. 

Paxton. 

Easton. 

Princeton. 

Gay  Head. 

Sudbury. 

Littleton. 

Wenham. 

Millbury. 

Wffliar 

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Appendix    G 


STATISTICS    OF    MILK    TRANSPORTATION    INTO    BOSTON. 

Amount  of  Milk  transported  into  Boston  during  1906  (Quarts). 


Boston  & 
Albany. 


Boston  & 
Maine. 


New  York, 

New  Haven  & 

Hartford. 


January,    . 

February, 

March, 

April, 

May, 

June, 

July, 

August, 

September, 

October,    . 

November, 

December, 


1,332,604 
1,205,300 
1,536,120 
1,587,060 
1,769,768 
1,759,177 
1,695,886 
1,630,869 
1,541,245 
1,524,968 
1,383,409 
1,382,567 


6,147,201 
5,320,639 
6,134,064 
6,051,116 
6,596,392 
6,964,326 
6,640,927 
6,372,150 
6,369,436 
6,266,043 
5,812,806 
6,054,571 


1,857,863 
1,699,607 
1,837,624 
1,902,188 
1,876,023 
1,913,221 
1,724,948 
1,610,180 
1,623,933 
1,686,887 
1,598,172 
1,638,630 


18,348,973 


74,729,671 


20,969,276 


Amount  of  Milk  transported  into  Boston  during  1907  (Quarts). 


January,    . 

February, 

March, 

April, 

May, 

June, 

July, 

August, 

September, 

October,    . 

November, 

December, 


1,386,749 
1,239,827 
1,445,484 
1,472,430 
1,638,766 
1,691,241 
1,648,596 
1,452,650 
1,170,560 
1,333,905 
1,117,282 
1,174,929 
16,772,419 


6,211,815 
5,523,853 
6,248,497 
6,185,519 
6,425,503 
6,487,446 
6,669,955 
5,970,386 
5,574,826 
5,037,707 
5,087,587 
5,171,399 
70,594,493 


1,586,577 
1,516,558 
1,705,893 
1,828,261 
2,008,164 
2,080,381 
1,933,398 
1,807,663 
1,708,373 
1,821,845 
1,788,725 
1,817,197 
21,603,035 


340 


Amount  of  Milk  transported  into  Boston  during  1908  (Quarts). 


Boston  & 
Albany. 


Boston  & 
Maine. 


New  York, 

New  Haven  < 

Hartford. 


January,   . 

February, 

March, 

April, 

May, 

June, 

July, 

August,     . 

September, 

October,    . 

November, 

December, 


1,241,221 
1,178,499 
1,147,551 
1,328,558 
1,524,713 
1,541,900 
1,349,026 
1,299,259 
1,317,270 
1,318,707 
1,169,345 
1,246,882 


5,293,584 
4,925,676 
5,695,014 
5,254,103 
5,536,851 
5,857,026 
5,964,741 
5,785,903 
5,493,163 
5,347,172 
5,017,521 
5,316,584 


1,934,791 
1,822,678 
2,013,002 
1,987,127 
2,029,476 
' 1,985,393 
1,858,796 
1,817,954 
1,806,924 
1,984,437 
1,840,372 
1,927,122 


15,662,931 


65,487,338 


23,008,072 


Amount  of  Milk  transported  into  Boston  during  1909  (Quarts). 


January,    . 

February, 

March, 

April, 

May, 

June, 

July, 

August,     . 

September, 

October,    . 

November, 

December, 


1,270,903 
1,154,657 
1,328,015 
1,394,808 
1,457,053 
1,436,432 
1,367,055 
1,229,491 
1,090,133 
1,295,629 
1,184,849 
1,239,835 
15,448,860 


5,033,372 
4,666,690 
5,161,949 
5,520,840 
6,273,596 
6,230,925 
5,925,875 
6,408,328 
5,202,991 
5,677,456 
5,496,995 
5,448,159 
67,047,176 


1,985,717 
1,985,717 
2,146,038 
2,130,839 
2,227,183 
2,308,070 
2,259,036 
2,166,728 
2,070,207 
2,322,280 
2,221,723 
2,376,820 
26,161,126 


341 


Amount  of  Milk  transported  into  Boston  during  1910  (Quarts). 


Boston  & 
Albany. 


Boston  & 
Maine. 


New  York, 

New  Haven  . 

Hartford. 


January,   . 

February, 

March, 

April, 

May, 

June, 

July, 

August,     . 

September, 

October,    . 

November, 

December, 


1,261,493 

1,129,956 

1,308,125 

1,319,982 

278,791 

965,608 

1,165,639 

891,673 

904,062 

943,466 

799,828 

837,902 


5,271,660 

4,839,106 

5,475,064^ 

6,343,029 

5,218,864 

5,638,992 

5,599,752 

4,679,669 

4,444,055 

4,482,585 

3,938,947 

3,893,803 


2,511,295 
2,238,771 
2,528,599 
2,410,224 
2,388,932 
2,266,220 
2,411,087 
2,037,164 
1,881,451 
2,004,881 
1,962,578 
1,891,326 


11,806,525 


59,825,526J^ 


26,532,528 


Amount  of  Milk  transported  into  Boston  during  1911  (Quarts). 


January,   . 

February, 

March, 

April, 

May, 

June, 

July, 

August, 

September, 

October,    . 

November, 

December, 


954,991 

3,920,531 

1,943,600 

778,233 

3,810,408 

1,798,264 

947,997 

3,874,625 

2,005,974 

970,421 

4,162,647 

1,819,823 

1,000,904 

4,581,592 

2,007,567 

1,059,773 

4,742,762 

2,023,276 

814,939 

6,206,046 

1,702,749 

807,635 

5,138,598 

1,918,993 

794,337 

5,285,888 

1,910,729 

904,345 

5,492,557 

1,795,274 

1,042,719 

5,675,805 

1,578,739 

957,011 

5,684,134 

1,681,167 

11,033,305 

58,575,593 

22,186,155 

342 


Amount  of  Milk  transported  into  Boston  during  1912  (Quarts). 


Boston  & 
Albany. 


Boston  & 
Maine. 


New  York, 

New  Haven  i 

Hartford. 


January,    . 

February, 

March, 

April, 

May, 

June, 

July, 

August,     . 

September, 

October,    . 

November, 

December, 


699,099 

663,677 

778,999 

784,973 

999,002 

852,059 

1,323,508 

1,065,419 

1,044,702 

907,501 

1,114,468 

651,882 


5,640,697 
5,463,501 
5,959,732 
5,887,748 
5,926,088 
6,448,720 
6,389,101 
6,367,389 
6,622,503 
6,801,240 
6,534,098 
6,916,685 


1,746,433 
1,660,086 
1,798,682 
1,669,220 
1,630,478 
1,718,713 
1,468,410 
1,478,834 
1,446,076 
1,472,292 
1,354,856 
1,422,419 


10,885,289 


74,957,502 


18,866,499 


Amount  of  Milk  transported  into  Boston  during  1913  (Quarts). 


January,   . 

February, 

March, 

April, 

May, 

June, 

July, 

August,     . 

September, 

October,    . 

November, 

December, 


429,311 

7,179,151 

1,446,881 

380,481 

6,693,732 

1,439,468 

444,513 

7,377,392 

1,546,405 

442,251 

7,438,618 

1,475,735 

500,943 

7,732,448 

1,748,368 

465,740 

7,520,704 

1,662,461 

451,915 

7,430,444 

1,725,201 

436,862 

6,820,345 

1,612,586 

490,677 

6,151,288 

1,550,894 

550,381 

5,913,873 

1,594,625 

586,978 

5,578,902 

1,505,290 

564,660 

6,290,180 

1,501,612 

,744,712 

82,127,077 

18,809,526 

343 


Amount  of  Milk  transported  into  Boston  during  1914  (Quarts). 


Boston  & 
Albany. 


Boston  & 
Maine. 


New  York, 

New  Haven  & 

Hartford. 


January,    . 

February, 

March, 

April, 

May, 

June, 

July, 

August,     . 

September, 

October,    . 

November, 

December, 


296,935 

288,116 

372,194 

393,512 

395,019 

445,397^ 

395,257^ 

506,954 

652,448 

306,271 

293,700 

584.223M 


6,604,900 
6,043,261 
6,629,606 
6,373,612 
7,091,511 
7,471,728 
7,109,790 
6,717,219 
6,279,826 
6,349,448 
6,182,944 
6,427,270 


1,502,442 
1,475,780 
1,640,016 
1,829,712 
1,896,857 
1,906,124 
1,716,631 
1,498,746 
1,450,443 
1,539,926 
1,625,447 
1,743,196 


4,930,027M 


79,281,115 


19,825,320 


344 


Appendix    H 


REPLIES  TO  QUESTIONNAIRE  RELATIVE  TO   LOCAL  MILK 

INSPECTION. 

In  April,  1915,  a  list  of  18  questions  was  sent  to  local  boards 
of  health.    These  questions  are  as  follows:  — 

1.  What  is  the  amount  of  your  appropriation  for  milk  inspection? 

2.  Have  you  a  milk  inspector? 

3.  If  so,  how  many  milk  licenses  has  he  issued  during  the  past  year? 

4.  What  laboratory  facilities  have  you  for  examining  milk?  , 

5.  How  many  chemical  examinations  of  milk  were  made? 

6.  How  many  bacteriological  examinations  of  milk  were  made? 

7.  How  many  permits  were  granted  under  chapter  744,  Acts  of  1914? 

8.  How  many  permits  were  refused  under  chapter  744,  Acts  of  1914? 

9.  How  many  licenses  or  permits  were  granted  to  owners  of  dairies  of 

five  cows  or  less? 

10.  What  is  the  total  number  of  dairies  in  your  town? 

11.  What  is  the  total  number  of  dairy  cows  in  your  town? 

12.  Prom  how  many  different  dairies  does  your  town  obtain  its  milk? 

13.  How  many  dairies  were  inspected  under  chapter  744,  Acts  of  1914? 

14.  In  what  cities  or  towns  were  these  dairies  located? 

15.  Were  any  of  these  dairies  inspected  by  the  boards  of  health  of  any 

city  or  town  other  than  your  town? 

16.  If  so,  how  many? 

17.  Were  there  any  epidemics  attributed  to  milk  during  the  past  year? 

18.  Describe  the  nature  of  any  such  epidemic,  the  number  of  cases,  and 

state  whether  or  not  it  was  investigated  by  a  State  Inspector  of 
Health. 

Of  the  353  cities  and  towns  72  made  no  reply  up  to  September 
1.  The  replies  from  the  balance  have  been  carefully  compiled, 
with  the  results  stated  below. 

Question  1.  —  What  is  the  amount  of  your  appropriation  for  milk 
inspection? 

No  answer, 72 

No  appropriation, 196 

Appropriation  not  specified, 22 

Specific  appropriation, 63 


345 

The  specific  appropriations  are  distributed  as  follows:  — 

Less  than  $100, 16 

Between  $100  and  $500, 24 

Between  $500  and  $1,000, 9 

Between  $1,000  and  $2,000, 6 

Between  $2,000  and  $2,500, 5 

Between  $3,000  and  $4,600, 4 

The  cities  and  towns  stating  that  the  appropriation  was  not 
specified  are  as  follows:  Amherst,  Attleboro,  Belmont,  Boston, 
Chicopee,  Dal  ton,  East  Bridgewater,  Framingham,  Gloucester, 
Great  Barrington,  Greenfield,  Lancaster,  Ludlow,  Lynn,  Marble- 
head,  Medway,  New  Bedford,  Orange,  Palmer,  Petersham, 
Wellesley  and  Weston. 

Most  of  these  localities  spent  but  little  money  upon  milk  in- 
spection, but  the  following  cities  maintain  good  laboratories  for 
several  employees,  and  spend  a  large  amount  of  money  per 
annum  for  this  proposition:  Boston,  Lynn  and  New  Bedford. 

The  following  cities  and  towns  have  specific  appropriations; 
those  in  italics  spend  more  than  $1,000  per  annum:  Adams, 
Andover,  Arlington,  Barnstable,  Beverly,  Blackstone,  Braintree, 
Brockton,  Brookline,  Cambridge,  Canton,  Chelsea,  Clinton,  Co- 
hasset,  Concord,  Danvers,  Dedham,  East  Longmeadow,  Everett, 
Fall  River,  Fitchburg,  Gardner,  Gosnold,  Haverhill,  Holyoke, 
Hudson,  Hull,  Ipswich,  Lawrence,  Lowell,  Marlborough,  Melrose, 
Middleborough,  Milton,  Montague,  Natick,  Needham,  Newton, 
North  Adams,  North  Attleborough,  North  Brookfield,  North- 
ampton, Rowe,  Salem,  Saugus,  Scituate,  Somerville,  Springfield, 
Taunton,  Walpole,  Waltham,  Ware,  Wareham,  Warren,  Water- 
town,  West  Brookfield,  Westborough,  Winchendon,  Winchester, 
Winthrop,  Woburn  and  Worcester. 

Question  2.  —  Have  you  a  milk  inspector? 

No  replies 72 

Yes, 115 

No, 166 

353 

The  following  cities  and  towns  from  which  no  reply  was 
received  are  known  to  have  milk  inspectors:  Lexington,  Maiden, 
Medford,  Newburyport,  Pittsfield,  Quincy,  Revere,  Westfield. 


346 

Question  3.  —  If  so,  how  many  milk  licenses  has  he  issued  during  the 
past  year? 

No  reply, 72 

None, 177 

Balance, 104 

Total  licenses  issued, 16,521 

The  total  licenses  issued  throughout  the  State  are,  of  course, 
much  greater  than  this,  as  each  town  and  city  having  a  milk 
inspector  failing  to  reply  to  this  questionnaire  issued  more  or 
less  licenses.  The  total  number  of  licenses  is  probably  1,200  to 
1,500  more. 

The  number  of  licenses  per  town  are  distributed  as  follows :  — 

Between      1  and       25, 33 

Between    25  and      50, 27 

Between    50  and     100, 19 

Between  100  and     200, 9 

Between  200  and    400, 4 

Between  400  and     800, 9 

Between  800  and  1,600, 1 

5,381, 1 

103 

Of  these  103  cities  and  towns  79,  or  76.7  per  cent.,  issued  less 
than  100  licenses,  total  number  of  licenses  being  2,603;  24,  or 
23.3  per  cent,  of  these  cities  and  towns  issued  more  than  100 
licenses  per  town,  the  total  number  of  licenses  being  13,918. 
The  average  number  of  licenses  was  158.  In  those  issuing  less 
than  100  licenses  the  average  number  was  33;  in  those  issuing 
more  than  100  licenses,  the  average  number  issued  was  681. 

Question  4-  —  What  laboratory  facilities  have  you  for  examining  milk? 

No  reply, .72 

None, 235 

Balance, 46 

353 

Chemical  and  bacteriological  apparatus  complete,        ....       18 

Babcock  machine, 11 

Babcock,  lactometer  and  bacteriological  outfit, 4 


347 


Babcock  and  bacteriological  outfit, 3 

Babcock,  sediment  tester  and  bacteriological  outfit, 3 

Chemical  laboratory, 3 

Babcock  and  lactometer, 2 

Babcock  and  sediment  tester, 1 

Sediment  tester, 1 


46 

Some  localities  send  samples  to  commercial  chemists  or  to 
other  milk  inspectors.  With  but  few  exceptions  the  outfits  are 
meager. 

Question  5.  —  How  many  chemical  examinations  of  milk  were  made? 

No  reply,      .  72 

None, *       .    222 

Balance, ' 59 


353 


Between         1  and 

25  analyses, 

Between      25  and 

50  analyses, 

Between      50  and 

100  analyses, 

Between     100  and 

200  analyses, 

Between     200  and 

400  analyses, 

Between     400  and 

800  analyses, 

Between     800  and 

1,600  analyses, 

Between  1,600  and 

3,200  analyses, 

Between  3,200  and 

6,400  analyses, 

Between  6,400  and  12,800  analyses, 

15,150,  .       . 

. 

6 
7 
9 
5 
15 
8 
3 
5 


Towns. 

Total 
Analyses. 

Average  per 
Town. 

Reports  of  analyses, 

59 

41,370 

700 

Less  than  100  analyses, 

22 

748 

36 

Between  100  and  1,000  analyses 

27 

10,586 

335 

Between  1,000  and  15,150  analyses 

8 

29,848 

3,731 

Between  1,000  and  2,697  analyses,     .... 

7 

14,698 

2,100 

In  nearly  all  places  where  less  than  100  analyses  were  made 
during  the  year  the  only  determination  made  was  the  fat  and 
possibly  the  specific  gravity. 


348 

Question  6.  —  How  many  bacteriological  examinations  of  milk  were 
made? 

No  reply, 72 

None, 237 

Balance, 44 


353 


Between 
Between 
Between 
Between 
Between 
Between 
Between 
Between 
Between 
6,834,     . 


1  and 

25  and 

50  and 

100  and 

200  and 

400  and 

800  and 

1,600  and 

3,200  and 


25  analyses, 

50  analyses, 

100  analyses, 

200  analyses, 

400  analyses, 

800  analyses, 

1,600  analyses, 

3,200  analyses, 

6,400  analyses, 


Towns. 

Total 
Analyses. 

Average  per 
Town. 

Reports  of  analyses, 

44 

21,532 

490 

Less  than  100  analyses,      ...... 

20 

854 

43 

Between  100  and  1,000  analyses 

19 

10,586 

555 

Between  1,000  and  6,834  analyses 

5 

14,324 

2,865 

Between  1,000  and  2,286  analyses 

4 

7,490 

1,872 

11  places  make  chemical  but  not  bacteriological  examinations. 
4  places  make  bacteriological  but  not  chemical  examinations. 

Question  7.  —  How  many  permits  were  granted  under  chapter  744, 
Acts  of  1914? 


The  answer  to  this  question  shows  that  with  but  few  exceptions 
practically  no  action  was  taken  under  this  statute.  This  was 
attributed  in  many  instances  to  the  prevalence  of  the  hoof  and 
mouth  disease,  whereby  inspections  of  the  dairies  was  rendered 
impossible,  but  it  was  disregarded  more  often  by  reason  of  the 
expense  which  would  have  occurred,  possibly  through  lack  of 
appropriations  and  possibly  because  it  would  be  considered  poor 
policy  to  spend  the  money  required  to  carry  out  the  provision 
of  the  act.  Furthermore,  many  cities  and  towns  rely  to  a  large 
extent  upon  the  inspection  made  by  other  cities  in  their  neighbor- 


349 


hood  when  the  milk  supply  to  all  these  localities  comes  from  a 
common  source. 


No  reply, 
None,    . 
Balance, 


72 
223 
58  » 


353 
Of  these  localities  — 
31  issued  less  than  25  permits. 
15  issued  from  25  to  50  permits. 
10  issued  from  50  to  100  permits. 
1  issued  132  permits. 
1  issued  285  permits. 
The  total  permits  were  1,840,  an  average  per  place  of  32. 

Of  those  12  localities  issuing  more  than  50  permits  1,103  were 
issued  with  an  average  of  93  permits  per  locality.  Of  the  46 
towns  issuing  less  than  50  permits  per  town,  417  permits  were 
issued,  averaging  9  permits  per  town.  The  town  reporting  the 
issuing  of  132  permits  had  inspected  only  45  dairies.  The  law 
under  which  these  permits  are  issued  requires  that  they  shall  be 
issued  only  after  an  inspection  of  the  premises  and  the  conditions 
under  which  the  milk  is  produced. 

Question  8.  —  How  many  permits  were  refused  under  chapter  744, 
Acts  of  1914? 

Eighteen  localities  refused  53  permits,  as  follows:  — 

Duxbury,     .  '     .       .       .        .14 

Brookline, 6 

Natick, 5 

Plymouth, 4 

Dedham, 3 

Lynn, 3 

Chicopee,  Dalton,  Pepperell,  Southbridge,  Spencer,  Winchester  and 
Yarmouth  1  each. 

Question  9.  —  How  many  licenses  or  permits  were  granted  to  owners 
of  dairies  of  5  cows  or  less? 

After  the  answers  to  this  question  had  been  compiled  it  was 
discovered  that  there  was  a  misunderstanding  in  the  meaning  of 


Needham,    . 

.      3 

Edgartown, 

.      2 

Fitchburg,   . 

.      2 

Newton, 

.      2 

Winchester, 

.      -2 

1  Issued  permits. 


* 


350 

the  question.  It  was  the  intention  to  obtain  the  number  of 
dairies  having  only  5  cows  or  less  and  not  buying  milk  from 
other  people.  The  answers  given  included  many  dealers  who 
were  in  the  milk  business  and  in  addition  owned  a  few  cows. 

Question  10.  —  What  is  the  total  number  of  dairies  in  your  town? 
Question  11.  —  What  is  the  total  number  of  dairy  cows  in  your  town? 

The  answers  to  these  two  questions  were  not  compiled  because 
so  many  rural  towns  made  no  reply.  Unfortunately  this  informa- 
tion was  greatly  desired  by  the  Milk  Board  in  order  to  ascertain 
the  number  of  dairies  and  dairy  cows  in  the  State,  and  in  order 
to  assist  it  in  choosing  localities  for  visiting.  Many  of  these 
towns  making  no  replies,  as  has  been  since  ascertained,  did  so 
by  reason  of  the  fact  that  they  carried  on  no  inspection  work, 
and  were  of  the  opinion  that  a  reply  would  be  of  no  value  to  the 
Department. 

Question  12.  —  From  how  many  different  dairies  does  your  town 
obtain  its  milk? 

The  answers  to  this  question  when  first  compiled  gave  a  total 
of  54,000  dairies,  but  there  was  undoubtedly  considerable  dupli- 
cation in  the  figures,  and  this  was  still  further  made  apparent 
after  the  answers  to  question  13  were  compiled.  For  this  reason 
a  second  compilation  was  made  for  the  purpose  of  carefully 
avoiding  any  duplication.  The  number  of  dairies  reported  by  the 
city  of  Boston  were  used  as  representing  the  combined  dairies 
supplying  Boston,  Cambridge,  Somerville,  Chelsea  and  the  other 
cities  surrounding  Boston,  and,  in  short,  an  attempt  was  made  to 
count  the  dairies  of  the  large  contractors  but  once.  This  idea 
was  carried  through  the  entire  list,  and  the  second  compilation 
gave  17,284  as  the  total  number  of  dairies  supplying  the  State, 
of  which  8,700  do  not  furnish  milk  to  Boston  and  vicinity.  These 
figures  are  not  by  any  means  accurate,  but  are  as  close  an 
approximation  as  can  be  made  from  the  returns  given.  Un- 
doubtedly the  dairy  figures  are  somewhat  low. 

Question  13.  —  How  many  dairies  were  inspected  under  chapter  744, 
Acts  of  1914? 

The  first  compilation  of  the  answer  to  this  question  showed 
that  but  7  per  cent,  of  the  dairies  supplying  milk  to  Massa- 
chusetts have  been  inspected.     These  figures  were  again  compiled 


351 

for  the  reason  described  above,  and  on  the  second  compilation 
the  total  dairies  inspected  were  estimated  to  be  10,318,  about 
3,000  of  which  were  inspected  by  cities  and  towns  other  than 
Boston,  the  city  of  Boston  inspecting  nearly  all  the  dairies  from 
which  its  milk  supply  is  obtained. 

Question  14-  —  In  what  cities  or  towns  were  these  dairies  located? 

The  responses  to  this  question  show  that  with  the  exception 
of  a  few  large  cities  and  towns  the  dairy  inspection  was  confined 
to  local  dairies,  the  Inspection  Department  making  no  attempt 
to-  go  out  of  town  for  the  purpose  of  inspecting  dairies  from 
which  the  town  received  its  milk. 

Question  15.  —  Were  any  of  these  dairies  inspected  by  the  boards  of 
health  of  any  city  or  town  other  than  your  town? 
Question  16.  —  If  so,  how  many? 

These  questions  were  introduced  for  the  purpose  of  ascertain- 
ing how  much  actual  duplication  of  milk  inspection  existed  in 
this  State.  A  study  of  the  law  would  certainly  convince  one 
that  at  least  one-half  of  the  dairies  supplying  milk  to  the  cities 
and  towns  in  this  State  should  have  been  inspected  by  the 
boards  of  health  of  from  3  to  10  different  cities  and  towns. 
The  compilation  of  the  answers  has  shown  that  there  was  but 
little  duplication  of  inspection,  notwithstanding  the  fact  that 
many  towns  replied  yes  to  question  15.  In  these  cases,  however, 
nearly  all  the  milk  raised  was  shipped  out  of  town,  and  the 
entire  inspection  made  under  these  conditions  was  naturally 
made  by  the  board  of  health  of  the  town  where  the  milk  was 
sold,  and  not  the  town  where  the  milk  was  produced,  and 
furthermore,  in  nearly  all  these  cases  the  local  boards  of  health 
made  no  inspection  whatsoever.  Owing  to  the  fact  that  except 
in  the  case  of  the  largest  cities  practically  no  inspection  of 
foreign  dairies  is  made,  the  duplication  of  inspection  which  one 
would  expect  to  occur  is  lacking.  Furthermore,  communities 
rely  to  a  large  measure  on  the  inspection  of  other  cities  and 
towns  to  safeguard  their  own  milk  supply.  For  example,  Revere, 
Chelsea,  Winthrop  and  Melrose  make  no  attempt  to  inspect  the 
premises  of  the  producers  supplying  the  large  contractors,  but 
depend  upon  the  inspection  made  by  the  city  of  Boston.  In  a 
similar  manner  the  town  of  Methuen  depends  almost  entirely 
upon  the  inspection  made  by  the  city  of  Lawrence,  because  the 
milk  supply   of   both   places   comes,   practically,  from   the  same 


352 

source.  One  town  replied  that  they  made  no  inspection  at  all, 
but  depended  upon  those  made  by  the  State  Board  of  Health. 
The  town  of  Brookline  reports  that  the  city  of  Boston  inspected 
nearly  two-thirds  of  the  dairies  inspected  by  Brookline.  Newton 
has  inspected  many  of  the  dairies  inspected  by  Boston  and 
Brookline.  The  city  of  Somerville  has  duplicated  some  of  the 
Boston  work.  No  doubt  all  the  cities  and  towns  receiving 
nearly  their  entire  supply  from  the  large  contractors  could  have 
made  the  same  report  if  they  had  carried  out  the  provisions  of 
chapter  744  of  the  Acts  of  1914. 

Question  17.  —  Were  there  any  epidemics  attributed  to  milk  during 
the  past  year? 

Question  18.  —  Describe  the  nature  of  any  such  epidemic,  the  number 
of  cases,  and  state  whether  or  not  it  was  investigated  by  a  State  Inspector 
of  Health. 

Mansfield.  —  Typhoid  fever  in  August,  September  and  October,  29 
cases.  Typhoid  fever  in  March  and  April,  1915,  21  cases.  Investigated 
by  Dr.  McKnight  of  Fall  River  and  Dr.  Kelley  of  Boston.  Dr.  Kelley 
and  Miss  Beckler  know  all  the  conditions  of  affairs  in  these  two  epi- 
demics. 

Natick.  —  One  place  where  scarlet  fever  was  found  and  one  dairy 
where  there  was  a  case  of  typhoid  was  investigated  by  the  State  In- 
spector besides  our  Board  and  Dairy  Inspector  on  our  request. 

Weymouth.  —  Twenty-six  cases  of  typhoid  fever  on  one  milk  supply. 
No  deaths.    Investigated  by  the  State  Board  of  Health. 

Beverly.  —  One  epidemic;  the  milk  from  New  Hampshire  dairy  dis- 
continued. Investigated  same  and  discontinued  milk  supply  coming 
to  Beverly.  The  disease  was  typhoid  fever.  The  State  Inspector  visited 
Beverly  a  number  of  times. 

Boston.  —  Two  epidemics,  septic  sore  throats.  First  outbreak  in 
Dorchester,  295  cases;  second  outbreak,  275.  Investigated  by  Dr. 
Champion. 

Brookline.  —  One  epidemic  of  septic  sore  throat,  —  about  20  cases. 
Not  investigated  by  State  Inspector  of  Health.  Such  drastic  action  was 
taken  that  the  milk  dealer  immediately  went  out  of  the  milk  business. 

Leominster.  —  There  was  one  typhoid  fever  epidemic  with  12  cases 
which  was  investigated  by  Dr.  Louis  Fish  of  Fitchburg. 

North  Adams.  —  One  epidemic  of  typhoid  fever.  Something  like  50 
cases  were  investigated  by  Dr.  Lyman  Asa  Jones. 

New  Bedford.  —  Two  epidemics  which  might  have  been  due  to  milk. 
Inspected  by  local  authorities  and  precautions  taken. 

Shirley.  —  Three  cases  of  scarlet  fever  investigated  by  Dr.  Simpson. 

Winthrop.  —  Several  cases  of  septic  sore  throat  reported  from  one 
dealer.    Took  samples  of  milk  and  went  to  State  House.    Story  told  to 


Appendix    I 


Map  Showing 
Milk  Producing  Sections 

Investigated 

by 

The  Milk  Board 

OF  THE 

Mass.  State  Dept.  of  Health 
1915 


®  BLACK  circles  denote  sections  visited. 


353 

Dr.  Hanson;  26  cases  of  septic  sore  throat;  made  notes,  and  sent  me 
to  Harvard  Medical,  Longwood  Avenue,  for  test.  Saw  Mr.  Brown. 
Said  I  could  not  get  results  of  test  until  Monday.  Took  one  of  the 
samples  to  biochemical  laboratory  and  got  results  at  3.  Streptococci. 
Closed  down  the  dairy,  came  back  and  took  samples  of  all  the  cows  and 
checked  all  up.  At  9  p.m.  we  had  the  3  infected  ones  found;  also  found 
that  there  were  59  cases  in  town.  The  State  Inspectors  were  here  the 
next  day,  at  2  p.m.,  and  looked  over  the  ground,  and  Dr.  Linenthall 
sent  the  Board  a  letter  telling  them  what  was  necessary  before  he  could 
open  again,  etc.  There  were  126  cases  all  told  of  this  sore  throat.  No 
milk  has  ever  been  sold  by  this  man  since,  and  he  went  out  of  business. 
It  was  the  best  thing  that  ever  happened,  as  it  was  a  lever  for  me  to 
bring  every  one  to  their  senses  as  to  the  conditions.  We  did  have  35 
cows  all  told  in  town,  from  2  to  14  in  herds;  to-day  we  have  none. 


354 


Appendix    J 


BIBLIOGRAPHY. 

Reports  of  the  Massachusetts  State  Board  of  Health  1890-1913. 

Records  and  files  of  the  Massachusetts  State  Board  of  Health. 

Practical  Hygiene,  Harrington  and  Richardson. 

The  Milk  Question,  Rosenau. 

Preventive  Medicine  and  Hygiene,  Rosenau. 

Pediatrics,  Rotch. 

Transactions  of  the  American  Association  for  Study  and  Prevention  of 
Infant  Mortality,  1910,  11,  12,  13,  14. 

Chemie  der  menschlichen  Nahrungs  und  Genussmittel,  Dr.  J.  Konig, 
fourth  edition. 

Journal  of  Hygiene,  Vols.  2  and  6. 

Infant  Mortality,  G.  Newman. 

Reports  of  Boston  Health  Department. 

Reports  of  the  English  Royal  Commission  on  Human  and  Animal  Tuber- 
culosis. 

Various  Bulletins,  United  States  Department  of  Agriculture. 

Various  Bulletins,  United  States  Public  Health  Service. 

Various  Bulletins,  New  York  City  Department  of  Health. 

Typhoid  Fever,  George  C.  Whipple. 

Transactions  of  the  Sixth  International  Congress  on  Tuberculosis. 

Transactions  of  the  Seventh  Annual  Meeting  of  the  National  Associa- 
tion for  the  Study  and  Prevention  of  Tuberculosis. 

Transactions  of  Federation  Internationale  de  Laiterie,  1905. 

Bacteriology  of  Milk,  Swithinbank  and  Newman. 

The  Commonsense  of  the  Milk  Question,  Spargo. 

The  Carrier  Problem  in  Infectious  Diseases,  Lodingham  and  Arkwright. 

Sources  and  Modes  of  Infection,  Chapin. 

The  Business  of  Dairying,  C.  B.  Lane. 

Report  of  Milk  Investigation  by  Chamber  of  Commerce,  Boston. 

Bovine  Tuberculosis  and  its  Control,  Moore. 

Modern  Medicine,  Osier. 

Acute  Contagious  Diseases,  Welch  and  Schamberg. 

Laws  of  Massachusetts. 

Proposed  Massachusetts  Laws. 

Report  Seattle  Department  of  Health  and  Sanitation,  1912,  13,  14. 

Journal  of  the  Royal  Sanitary  Institute  (files). 

American  Journal  of  Public  Health  (files). 


355 

Collected  Studies  from  the  Bureau  of  Laboratories  of  the  New  York 

City  Department  of  Health,  Park. 
Report  of  Committee  of  One  Hundred  on  National  Vitality. 
Milk  and  its  Relation  to  the  Public  Health,  Savage. 
Files  of  the  Reports  of  the  United  States  Public  Health  Service  from 

1908-15. 
Reports  of  Federal  Census  of  1900  and  1910. 
Agricultural  Year  Books,   United   States   Department   of  Agriculture 

(various  years,  1900-12). 
Special  Reports  of  United  States  Public  Health  Service :  — 

"Milk  and  its  Relation  to  the  Public  Health." 

Bulletin  No.  51,  Hygienic  Laboratory  of  the  United  States  Public 
Health  and  Marine  Hospital  Service. 

Reports  on  the  Origin  and  Prevalence  of  Typhoid  Fever  in  the  District 
of  Columbia. 

Bulletins  Nos.  35,  44,  52  and  78  of  the  Hygienic  Laboratory,  United 
States  Public  Health  and  Marine  Hospital  Service. 

Reports  of  the  State  Board  of  Agriculture  of  Massachusetts. 

"Infectiousness  of  Milk,"   published  by  Massachusetts  Society  for 
Promotion  of  Agriculture  (repo'rt  by  Dr.  Harold  C.  Ernst). 
Massachusetts  Census  Reports. 
Massachusetts  Polls  and  Taxes. 
Massachusetts  Public  Service  Commission  Reports. 
Massachusetts  Agricultural  College  Publications. 
Reports  of  Boston  Chamber  of  Commerce  Statistics  Department. 
Cattle  Feeding,  Ormsby. 

Files  of  — 

Hoard's  Dairyman. 

Berkshire  World  (devoted  partly  to  Jersey  cattle  interests). 

Rural  New  Yorker. 

New  England  Homestead. 

Country  Gentleman. 

Study  of  Breeds,  Shaw. 

Massachusetts  Department  of  Animal  Industry  Reports. 

Bureau  of  Markets,  Statistics. 
Massachusetts  State  Grange  Reports. 

Agricultural  Reports  of  Various  States  and  Dominion  of  Canada. 
Statements  by  letter  from  — 

Cattle  Associations. 

Milk  and  Baby  Hygiene  Associations. 
Catalogues  of  Milk  Utensils  and  Appliances. 
Dairymen  on  Cost  of  producing  Milk. 
Records  of  Legislative  Committee  on  Milk,  1911. 


356 


Appendix    K 


LIST  OF  CONFERENCES  AND  MEETINGS  ATTENDED  OR 
OF  PERSONS  INTERVIEWED  RELATIVE  TO  THE  MILK 
QUESTION. 

Massachusetts  State  Grange  Executive  Committee  Meetings. 

New  England  Holstein-Friesian  Cattle  Breeders'  Association  Meeting. 

Massachusetts  Milk  Inspectors  Association  Meeting. 

Legislative  Hearings. 

Meeting  at  Century  Club  (Dr.  North's  Lecture). 

Field  Meetings  of  Massachusetts  State  Grange  (25),  and  interviews 
with  many  persons  at  these  meetings. 

Dairymen  interviewed  in  Massachusetts,  Vermont,  New  Hampshire  and 
Province  of  Quebec  while  on  inspection  trips  (probably  150  to  200). 

Hon.  Wilfrid  Wheeler,  Secretary,  State  Board  of  Agriculture. 

Dr.  L.  0.  Howard,  Commissioner,  Massachusetts  Department  of  Animal 
Industry. 

P.  M.  Harwood,  Agent,  State  Dairy  Bureau. 

Hon.  Chas.  M.  Gardner,  Past  Master,  Massachusetts  State  Grange,  Chair- 
man, State  Dairy  Bureau. 

Mr.  Tinkham  of  the  Rhode  Island  Inquiry  Board. 

Dr.  Stone,  Massachusetts  State  Board  of  Insanity. 

Dr.  Frank  Woods  (Holyoke)  on  value  of  fresh  milk  for  babies. 

Dr.  Mark  W.  Richardson  on  value  of  fresh  milk  for  babies. 

Members  of  the  Massachusetts  State  Board  of  Agriculture. 

J.  L.  Ellsworth,  Past  Secretary,  Massachusetts  State  Board  of  Agri- 
culture. 

Mr.  Sacker,  President,  New  England  Cattle  Dealers'  Association. 

Various  dealers  in  milch  cows  at  Brighton. 

Dr.  Davis  (Hood  &  Co.,  Charlestown  plant). 

Mr.  Park  (Hood  &  Co.,  Lynn  plant). 

Mr.  Whiting  (Whiting's  plant  in  Charlestown). 

Mr.  Blossom  (Hood  Agent,  North  Hatley,  Que.). 

Mr.  Lamson  (United  States  Dept.  of  Agriculture,  Bureau  of  Chemistry, 
North  Hatley,  Que.). 

Mr.  Myron  T.  Pierce  (Attorney,  Milk  Consumers'  League). 

Mr.  J.  C.  Orcutt  (Assistant  Secretary,  Boston  Chamber  of  Commerce). 

Westport,  Maine,  Agricultural  Fair. 

Segreganset  Agricultural  School. 

Essex  County  Agricultural  School. 


357 

Mr.  Lombard,  Inspector,  Massachusetts  State  Board  of  Agriculture 
Dairy  Bureau. 

Mr.  J.  F.  Bresnahan,  Milk  Inspector,  Fitchburg. 

Mr.  G.  A.  Flanagan,  Milk  Inspector,  Lynn. 

Dr.  Stanbridge,  Milk  Inspector,  Winchendon. 

Dr.  P.  H.  Mullowney,  Department  Commissioner,  Boston  Health  De- 
partment. 

Dr.  Thos.  E.  Maloney,  Board  of  Health,  Fall  River. 

Mr.  W.  E.  Ward,  Milk  Inspector,  Brookline. 

Mr.  A.  W.  Russell,  Agent,  Board  of  Health,  Newton. 

Mr.  Geo.  Barrow,  Milk  dealer,  Waltham. 

Mr.  Childs,  Milk  dealer,  Waltham. 

Dr.  H.  W.  Pierce,  Massachusetts  State  Department  of  Animal  Industry. 

Dr.  Milliken,  Chairman,  Barnstable  Board  of  Health. 

Mr.  Mecarta,  Milk  Inspector,  Barnstable  Board  of  Health. 

Mr.  John  Cook,  Chairman,  Provincetown  Board  of  Health. 

Mr.  G.  L.  Berg,  Milk  Inspector,  Worcester. 

Mr.  H.  E.  Bowman,  Milk  Inspector,  Somerville. 

Dr.  F.  G.  Curtis,  Chairman,  Newton  Board  of  Health. 

Various  officials  of  the  New  York  City  Health  Department,  including 
the  Commissioner  of  Health,  the  Chief  of  the  Division  of  Foods,  the 
Chief  of  the  Division  of  Milk  Inspection,  the  Chief  and  the  Epidemi- 
ologist of  the  Bureau  of  Infectious  Diseases. 

Convention  of  Certified  Milk  Producers'  Association  at  Atlantic  City, 
N.J. 

Convention  of  International  Milk  Inspectors'  Association  at  Washington. 

Convention  of  Official  Agricultural  Chemists,  Washington. 

Convention  of  the  American  Public  Health  Association,  Rochester,  N.  Y. 

Plant  of  the  George  M.  Oyster  Milk  Company,  Washington,  D.  C. 

Plant  of  the  Borden  Condensed  Milk  Company,  New  York  City. 

Plant  of  Slawson  Decker-Sheffield  Farms  Company,  New  York  City. 

Plants  of  H.  P.  Hood  &  Sons  at  Boston  and  Lynn,  Mass.,  Newport,  Vt., 
and  Unity,  Me. 

Plants  of  D.  Whiting  &  Sons,  Boston,  Mass.,  Thorndike,  Newbury, 
uEtna  and  Pittsfield,  Me. 

Plants  of  C.  Brigham  Company,  Cambridge. 

Plants  of  the  Turner  Centre  Dairying  Association  at  Auburn,  Benton, 
Wiscasset  and  Unity,  Me. 

Dr.  Fred  Meader,  Chief  of  Division  of  Communicable  Diseases  of  the 
New  York  State  Health  Department  at  Albany. 

Dr.  Herman  Biggs,  New  York  State  Commissioner  of  Health,  New  York 
City. 

Dr.  A.  J.  Chesley,  Chief,  Division  of  Preventable  Diseases,  Minnesota 
Board  of  Health,  at  Rochester. 

Assistant  Surgeon  General  J.  W.  Trask,  United  States  Public  Health 
Service,  at  Rochester. 


358 

Hon.  W.  T.  Guptill,  State  Commissioner  of  Agriculture,  A.  M.  G.  Soule, 
Chief  of  Bureau  of  Inspection,  and  Mr.  J.  H.  Blanchard,  State  Dairy- 
Instructor,  all  of  the  Department  of  Agriculture  of  Maine. 

Dr.  Ivan  C.  Weld,  Secretary,  International  Milk  Inspectors'  Association. 

Mr.  Julius  Hortvet,  State  Chemist,  Minnesota,  and  member  of  the 
Joint  Committee  on  Standards,  United  States  Department  of  Agri- 
culture. 

Mr.  Jones,  Associate  Chief,  Bureau  of  Chemistry,  United  States  Depart- 
ment of  Agriculture. 

Hon.  F.  A.  Stadtmueller,  Dairy  and  Food  Commissioner  of  Connecticut. 

Dr.  Charles  V.  Chapin,  Superintendent  of  Health,  Providence,  R.  I. 

E.  L.  Bradford,  Manager,  Turner  Centre  Dairying  Association,  and 
many  others. 


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